Combined Approach to Stroke Thrombectomy Using a Novel Short Flexible Aspiration Catheter with a Stent Retriever
Background: Large-bore aspiration catheters enabling greater flow rates and suction force for mechanical thrombectomy might improve outcomes in patients with stroke secondary to large-vessel occlusion. Complete or near-complete reperfusion after a single thrombectomy pass (first-pass effect) is asso...
| Authors: | ; ; ; ; ; ; ; ; ; ; ; |
|---|---|
| Format: | Article |
| Status: | Published version |
| Publication date: | 2021 |
| Country: | España |
| Institution: | Universidad de Barcelona |
| Repository: | Dipòsit Digital de la UB |
| OAI Identifier: | oai:diposit.ub.edu:2445/179818 |
| Online Access: | https://hdl.handle.net/2445/179818 |
| Access Level: | Open access |
| Keyword: | Isquèmia cerebral Neurocirurgia Cerebral ischemia Nervous system--Surgery |
| _version_ | 1878736162077540352 |
|---|---|
| author | Remollo, Sebastian |
| author2 | Terceño, Mikel Werner, Mariano Castaño, Carlos Hernández-Pérez, María Blasco, Jordi San Román, Luis Daunis-i-Estadella, Pepus Thió-Henestrosa, Santiago Cuba, Víctor Gimeno, Alfredo Puig, Josep |
| author2_role | author author author author author author author author author author author |
| author_browse | Blasco, Jordi Castaño, Carlos Cuba, Víctor Daunis-i-Estadella, Pepus Gimeno, Alfredo Hernández-Pérez, María Puig, Josep Remollo, Sebastian San Román, Luis Terceño, Mikel Thió-Henestrosa, Santiago Werner, Mariano |
| author_facet | Remollo, Sebastian Terceño, Mikel Werner, Mariano Castaño, Carlos Hernández-Pérez, María Blasco, Jordi San Román, Luis Daunis-i-Estadella, Pepus Thió-Henestrosa, Santiago Cuba, Víctor Gimeno, Alfredo Puig, Josep |
| author_role | author |
| collection | Dipòsit Digital de la UB |
| description | Background: Large-bore aspiration catheters enabling greater flow rates and suction force for mechanical thrombectomy might improve outcomes in patients with stroke secondary to large-vessel occlusion. Complete or near-complete reperfusion after a single thrombectomy pass (first-pass effect) is associated with improved clinical outcomes. We assessed the efficacy and safety of novel MIVI Q™ aspiration catheters in combination with stent-retriever devices. Methods: We retrospectively analyzed demographics, procedure characteristics, and clinical data from consecutive patients with acute anterior large-vessel occlusion treated with a combined approach using MIVI Q™ aspiration catheters and stent retrievers. Reperfusion was defined according to the modified thrombolysis in cerebral infarction (mTICI) score. Clinical outcomes were measured by the National Institute of Health Stroke Scale (NIHSS) and modified Rankin scale (mRS) scores. Results: We included 52 patients (median age, 75 y IQR: 64-83); 31 (59.6%) women; 14 (26.9%) with terminal internal carotid artery occlusions, 26 (50%) middle cerebral artery (MCA) segment M1 occlusions, and 12 (23.1%) MCA segment M2 occlusions; median NIHSS score at admission was 19 (IQR: 13-22). After the first pass, 25 (48%) patients had mTICI ≥ 2c. At the end of the procedure, 47 (90.4%) had mTICI ≥ 2b and 35 (67.3%) had mTICI ≥ 2c. No serious device-related adverse events were observed. Symptomatic intracranial hemorrhage developed in 1 patient. Mean NIHSS score was 13 at 24 h and 5 at discharge. At 90 days, 24 (46.2%) patients were functionally independent (mRS 0-2). Conclusion: This preliminary study found good efficacy and safety for MIVI Q™ aspiration catheters used in combination with stent-retriever devices. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | ES_8a1d605a6fc0af3e569f32003781f7d9 |
| institution | Universidad de Barcelona |
| instname_str | Universidad de Barcelona |
| network_acronym_str | ES |
| network_name_str | España |
| oai_identifier_str | oai:diposit.ub.edu:2445/179818 |
| publishDate | 2021 |
| publishDateSort | 2021 |
| publisher | Springer |
| publisherStr | Springer |
| reponame_str | Dipòsit Digital de la UB |
| spelling | Combined Approach to Stroke Thrombectomy Using a Novel Short Flexible Aspiration Catheter with a Stent Retriever Remollo, Sebastian Terceño, Mikel Werner, Mariano Castaño, Carlos Hernández-Pérez, María Blasco, Jordi San Román, Luis Daunis-i-Estadella, Pepus Thió-Henestrosa, Santiago Cuba, Víctor Gimeno, Alfredo Puig, Josep Isquèmia cerebral Neurocirurgia Cerebral ischemia Nervous system--Surgery Background: Large-bore aspiration catheters enabling greater flow rates and suction force for mechanical thrombectomy might improve outcomes in patients with stroke secondary to large-vessel occlusion. Complete or near-complete reperfusion after a single thrombectomy pass (first-pass effect) is associated with improved clinical outcomes. We assessed the efficacy and safety of novel MIVI Q™ aspiration catheters in combination with stent-retriever devices. Methods: We retrospectively analyzed demographics, procedure characteristics, and clinical data from consecutive patients with acute anterior large-vessel occlusion treated with a combined approach using MIVI Q™ aspiration catheters and stent retrievers. Reperfusion was defined according to the modified thrombolysis in cerebral infarction (mTICI) score. Clinical outcomes were measured by the National Institute of Health Stroke Scale (NIHSS) and modified Rankin scale (mRS) scores. Results: We included 52 patients (median age, 75 y IQR: 64-83); 31 (59.6%) women; 14 (26.9%) with terminal internal carotid artery occlusions, 26 (50%) middle cerebral artery (MCA) segment M1 occlusions, and 12 (23.1%) MCA segment M2 occlusions; median NIHSS score at admission was 19 (IQR: 13-22). After the first pass, 25 (48%) patients had mTICI ≥ 2c. At the end of the procedure, 47 (90.4%) had mTICI ≥ 2b and 35 (67.3%) had mTICI ≥ 2c. No serious device-related adverse events were observed. Symptomatic intracranial hemorrhage developed in 1 patient. Mean NIHSS score was 13 at 24 h and 5 at discharge. At 90 days, 24 (46.2%) patients were functionally independent (mRS 0-2). Conclusion: This preliminary study found good efficacy and safety for MIVI Q™ aspiration catheters used in combination with stent-retriever devices. Springer https://hdl.handle.net/2445/179818 |
| spellingShingle | Combined Approach to Stroke Thrombectomy Using a Novel Short Flexible Aspiration Catheter with a Stent Retriever Remollo, Sebastian Isquèmia cerebral Neurocirurgia Cerebral ischemia Nervous system--Surgery |
| status_str | publishedVersion |
| title | Combined Approach to Stroke Thrombectomy Using a Novel Short Flexible Aspiration Catheter with a Stent Retriever |
| title_full | Combined Approach to Stroke Thrombectomy Using a Novel Short Flexible Aspiration Catheter with a Stent Retriever |
| title_fullStr | Combined Approach to Stroke Thrombectomy Using a Novel Short Flexible Aspiration Catheter with a Stent Retriever |
| title_full_unstemmed | Combined Approach to Stroke Thrombectomy Using a Novel Short Flexible Aspiration Catheter with a Stent Retriever |
| title_short | Combined Approach to Stroke Thrombectomy Using a Novel Short Flexible Aspiration Catheter with a Stent Retriever |
| title_sort | Combined Approach to Stroke Thrombectomy Using a Novel Short Flexible Aspiration Catheter with a Stent Retriever |
| topic | Isquèmia cerebral Neurocirurgia Cerebral ischemia Nervous system--Surgery |
| topic_facet | Isquèmia cerebral Neurocirurgia Cerebral ischemia Nervous system--Surgery |
| url | https://hdl.handle.net/2445/179818 |