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Intra-arterial pulse wave analysis during thrombectomy for the assessment of collateral status – A feasibility study

PURPOSE: Knowledge of the collateralization of an occluded vessel is important for the risk-benefit analysis of difficult revascularization maneuvers during mechanical thrombectomy. If the territory behind a clot is well perfused, one could desist from performing a risky thrombectomy maneuver. The a...

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Autores principales: Sandmann, Johanna, Sichtermann, Thorsten, Müschenich, Franziska Sonja, Nasri, Hadi, Heringer, Sarah, Mpotsaris, Anastasios, Kramer, Martin, Wiesmann, Martin, Nikoubashman, Omid
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6328207/
https://www.ncbi.nlm.nih.gov/pubmed/30629721
http://dx.doi.org/10.1371/journal.pone.0210572
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author Sandmann, Johanna
Sichtermann, Thorsten
Müschenich, Franziska Sonja
Nasri, Hadi
Heringer, Sarah
Mpotsaris, Anastasios
Kramer, Martin
Wiesmann, Martin
Nikoubashman, Omid
author_facet Sandmann, Johanna
Sichtermann, Thorsten
Müschenich, Franziska Sonja
Nasri, Hadi
Heringer, Sarah
Mpotsaris, Anastasios
Kramer, Martin
Wiesmann, Martin
Nikoubashman, Omid
author_sort Sandmann, Johanna
collection PubMed
description PURPOSE: Knowledge of the collateralization of an occluded vessel is important for the risk-benefit analysis of difficult revascularization maneuvers during mechanical thrombectomy. If the territory behind a clot is well perfused, one could desist from performing a risky thrombectomy maneuver. The arterial pulse pressure curve may serve as an indicator for the collateralization of an occluded target vessel. We investigated the feasibility of arterial pulse measurements with a standard microcatheter. METHODS: We measured the intra-arterial blood pressure proximal and distal to the clot in 40 thrombectomy maneuvers in a porcine stroke model. We used a microcatheter (Trevo Pro 18, Stryker, Kalamazoo, CA, USA), a pressure transducer (MEMSCAP SP844), an AdInstruments Powerlab 16/35 workstation, and LabChart 8 Software (AdInstruments, Dunedin, New Zealand). RESULTS: Median arterial blood pressure proximal and distal to the clot was 96.0 mmHg (IQR, 23.8 mmHg) and 47.5 mmHg (IQR, 43.5 mmHg), respectively (p < .001). The median difference between systolic maximum and diastolic minimum proximal and distal to the clot decreased significantly from 1.8 mmHg (IQR, 3.6 mmHg) to 0.0 mmHg (IQR, 0.5 mmHg) (p < .001). There was loss of the curve in 26 of 40 cases and loss of pressure in 23 of 40 cases (p = .008). There was no significant correlation between vessel diameter and either loss of the pulse pressure curve (p = .20) or overall pressure loss (p = .31). CONCLUSION: It is possible to measure the pulse pressure proximal and distal to the clot with a standard microcatheter used during mechanical thrombectomy.
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spelling pubmed-63282072019-02-01 Intra-arterial pulse wave analysis during thrombectomy for the assessment of collateral status – A feasibility study Sandmann, Johanna Sichtermann, Thorsten Müschenich, Franziska Sonja Nasri, Hadi Heringer, Sarah Mpotsaris, Anastasios Kramer, Martin Wiesmann, Martin Nikoubashman, Omid PLoS One Research Article PURPOSE: Knowledge of the collateralization of an occluded vessel is important for the risk-benefit analysis of difficult revascularization maneuvers during mechanical thrombectomy. If the territory behind a clot is well perfused, one could desist from performing a risky thrombectomy maneuver. The arterial pulse pressure curve may serve as an indicator for the collateralization of an occluded target vessel. We investigated the feasibility of arterial pulse measurements with a standard microcatheter. METHODS: We measured the intra-arterial blood pressure proximal and distal to the clot in 40 thrombectomy maneuvers in a porcine stroke model. We used a microcatheter (Trevo Pro 18, Stryker, Kalamazoo, CA, USA), a pressure transducer (MEMSCAP SP844), an AdInstruments Powerlab 16/35 workstation, and LabChart 8 Software (AdInstruments, Dunedin, New Zealand). RESULTS: Median arterial blood pressure proximal and distal to the clot was 96.0 mmHg (IQR, 23.8 mmHg) and 47.5 mmHg (IQR, 43.5 mmHg), respectively (p < .001). The median difference between systolic maximum and diastolic minimum proximal and distal to the clot decreased significantly from 1.8 mmHg (IQR, 3.6 mmHg) to 0.0 mmHg (IQR, 0.5 mmHg) (p < .001). There was loss of the curve in 26 of 40 cases and loss of pressure in 23 of 40 cases (p = .008). There was no significant correlation between vessel diameter and either loss of the pulse pressure curve (p = .20) or overall pressure loss (p = .31). CONCLUSION: It is possible to measure the pulse pressure proximal and distal to the clot with a standard microcatheter used during mechanical thrombectomy. Public Library of Science 2019-01-10 /pmc/articles/PMC6328207/ /pubmed/30629721 http://dx.doi.org/10.1371/journal.pone.0210572 Text en © 2019 Sandmann et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Sandmann, Johanna
Sichtermann, Thorsten
Müschenich, Franziska Sonja
Nasri, Hadi
Heringer, Sarah
Mpotsaris, Anastasios
Kramer, Martin
Wiesmann, Martin
Nikoubashman, Omid
Intra-arterial pulse wave analysis during thrombectomy for the assessment of collateral status – A feasibility study
title Intra-arterial pulse wave analysis during thrombectomy for the assessment of collateral status – A feasibility study
title_full Intra-arterial pulse wave analysis during thrombectomy for the assessment of collateral status – A feasibility study
title_fullStr Intra-arterial pulse wave analysis during thrombectomy for the assessment of collateral status – A feasibility study
title_full_unstemmed Intra-arterial pulse wave analysis during thrombectomy for the assessment of collateral status – A feasibility study
title_short Intra-arterial pulse wave analysis during thrombectomy for the assessment of collateral status – A feasibility study
title_sort intra-arterial pulse wave analysis during thrombectomy for the assessment of collateral status – a feasibility study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6328207/
https://www.ncbi.nlm.nih.gov/pubmed/30629721
http://dx.doi.org/10.1371/journal.pone.0210572
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