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Comparison of First-Pass Effect in Aspiration vs. Stent-Retriever for Acute Intracranial ICA Occlusion

The purpose of this study is to evaluate the best endovascular approach (aspiration or stent-retriever) and the impact of stent retriever size and length on clinical and angiographic outcomes in patients with acute intracranial ICA occlusion. We conducted a retrospective analysis of a prospective da...

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Autores principales: Hernández, David, Serrano, Elena, Molins, Gemma, Zarco, Federico, Chirife, Oscar, Werner, Mariano, Lara, Blanca, Ramos, Anna, Llull, Laura, Requena, Manuel, Cuevas, Marta de Dios las, Remollo, Sebastián, Piñana, Carlos, López-Rueda, Antonio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9279887/
https://www.ncbi.nlm.nih.gov/pubmed/35847206
http://dx.doi.org/10.3389/fneur.2022.925159
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author Hernández, David
Serrano, Elena
Molins, Gemma
Zarco, Federico
Chirife, Oscar
Werner, Mariano
Lara, Blanca
Ramos, Anna
Llull, Laura
Requena, Manuel
Cuevas, Marta de Dios las
Remollo, Sebastián
Piñana, Carlos
López-Rueda, Antonio
author_facet Hernández, David
Serrano, Elena
Molins, Gemma
Zarco, Federico
Chirife, Oscar
Werner, Mariano
Lara, Blanca
Ramos, Anna
Llull, Laura
Requena, Manuel
Cuevas, Marta de Dios las
Remollo, Sebastián
Piñana, Carlos
López-Rueda, Antonio
author_sort Hernández, David
collection PubMed
description The purpose of this study is to evaluate the best endovascular approach (aspiration or stent-retriever) and the impact of stent retriever size and length on clinical and angiographic outcomes in patients with acute intracranial ICA occlusion. We conducted a retrospective analysis of a prospective database of consecutive patients with acute intracranial ICA occlusion undergoing endovascular treatment in four Comprehensive Stroke Center between June-2019 and December-2020. We include 121 patients; Stent-retriever (SR) was used as first technical approach in 107 patients (88.4%) and aspiration was used in 14 patients (11.6%). SR group had higher rate of FPE compared to aspiration group (29 vs. 0%, p = 0.02). In SR subgroup, treatment highlighted higher FPE in the 6 × 50 SR (37.7%), than in the rest of the SR which are 21.2% (4–5 mm size and 20–50 mm length SR) and 19% (6 mm size and 25–40 mm length SR), but it was not found to be statistically significant. There were no other significant differences across the groups regarding primary angiographic or clinical outcomes. In our intracranial ICA occlusion series, stent retrievers were superior to direct aspiration in obtaining FPEs and mFPEs, and longer devices achieved better results with no statistically significant difference. Further studies evaluating the effects of different ICA clot removal approaches are warranted to confirm these results.
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spelling pubmed-92798872022-07-15 Comparison of First-Pass Effect in Aspiration vs. Stent-Retriever for Acute Intracranial ICA Occlusion Hernández, David Serrano, Elena Molins, Gemma Zarco, Federico Chirife, Oscar Werner, Mariano Lara, Blanca Ramos, Anna Llull, Laura Requena, Manuel Cuevas, Marta de Dios las Remollo, Sebastián Piñana, Carlos López-Rueda, Antonio Front Neurol Neurology The purpose of this study is to evaluate the best endovascular approach (aspiration or stent-retriever) and the impact of stent retriever size and length on clinical and angiographic outcomes in patients with acute intracranial ICA occlusion. We conducted a retrospective analysis of a prospective database of consecutive patients with acute intracranial ICA occlusion undergoing endovascular treatment in four Comprehensive Stroke Center between June-2019 and December-2020. We include 121 patients; Stent-retriever (SR) was used as first technical approach in 107 patients (88.4%) and aspiration was used in 14 patients (11.6%). SR group had higher rate of FPE compared to aspiration group (29 vs. 0%, p = 0.02). In SR subgroup, treatment highlighted higher FPE in the 6 × 50 SR (37.7%), than in the rest of the SR which are 21.2% (4–5 mm size and 20–50 mm length SR) and 19% (6 mm size and 25–40 mm length SR), but it was not found to be statistically significant. There were no other significant differences across the groups regarding primary angiographic or clinical outcomes. In our intracranial ICA occlusion series, stent retrievers were superior to direct aspiration in obtaining FPEs and mFPEs, and longer devices achieved better results with no statistically significant difference. Further studies evaluating the effects of different ICA clot removal approaches are warranted to confirm these results. Frontiers Media S.A. 2022-06-30 /pmc/articles/PMC9279887/ /pubmed/35847206 http://dx.doi.org/10.3389/fneur.2022.925159 Text en Copyright © 2022 Hernández, Serrano, Molins, Zarco, Chirife, Werner, Lara, Ramos, Llull, Requena, Cuevas, Remollo, Piñana and López-Rueda. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Hernández, David
Serrano, Elena
Molins, Gemma
Zarco, Federico
Chirife, Oscar
Werner, Mariano
Lara, Blanca
Ramos, Anna
Llull, Laura
Requena, Manuel
Cuevas, Marta de Dios las
Remollo, Sebastián
Piñana, Carlos
López-Rueda, Antonio
Comparison of First-Pass Effect in Aspiration vs. Stent-Retriever for Acute Intracranial ICA Occlusion
title Comparison of First-Pass Effect in Aspiration vs. Stent-Retriever for Acute Intracranial ICA Occlusion
title_full Comparison of First-Pass Effect in Aspiration vs. Stent-Retriever for Acute Intracranial ICA Occlusion
title_fullStr Comparison of First-Pass Effect in Aspiration vs. Stent-Retriever for Acute Intracranial ICA Occlusion
title_full_unstemmed Comparison of First-Pass Effect in Aspiration vs. Stent-Retriever for Acute Intracranial ICA Occlusion
title_short Comparison of First-Pass Effect in Aspiration vs. Stent-Retriever for Acute Intracranial ICA Occlusion
title_sort comparison of first-pass effect in aspiration vs. stent-retriever for acute intracranial ica occlusion
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9279887/
https://www.ncbi.nlm.nih.gov/pubmed/35847206
http://dx.doi.org/10.3389/fneur.2022.925159
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