Direct Common Carotid Artery Puncture: Rescue Mechanical Thrombectomy Strategy in Acute Ischemic Stroke
Purpose In a minority of cases, the transfemoral approach cannot be performed due to unfavorable anatomical barriers. In such cases, direct common carotid artery puncture (DCCAP) is an important alternative for rescue mechanical thrombectomy. The purpose of this study was to evaluate the efficacy an...
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| Format: | Article |
| Language: | English |
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Korean Society of Interventional Neuroradiology
2020-07-01
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| Series: | Neurointervention |
| Subjects: | |
| Online Access: | http://neurointervention.org/upload/pdf/neuroint-2020-00010.pdf |
| _version_ | 1797330761422995456 |
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| author | Cetin Kursad Akpinar Erdem Gurkas Ozlem Aykac Yusuf Inanc Semih Giray Atilla Ozcan Ozdemir |
| author_facet | Cetin Kursad Akpinar Erdem Gurkas Ozlem Aykac Yusuf Inanc Semih Giray Atilla Ozcan Ozdemir |
| author_sort | Cetin Kursad Akpinar |
| collection | DOAJ |
| description | Purpose In a minority of cases, the transfemoral approach cannot be performed due to unfavorable anatomical barriers. In such cases, direct common carotid artery puncture (DCCAP) is an important alternative for rescue mechanical thrombectomy. The purpose of this study was to evaluate the efficacy and safety of DCCAP in patients with an unaccessible femoral route for mechanical thrombectomy. Materials and Methods This is a retrospective study using data in the Turkish Interventional Neurology Database recorded between January 2015 and April 2019. Twenty-five acute stroke patients treated with DCCAP were analyzed in this study. Among 25 cases with carotid puncture, 4 cases were excluded due to an aborted thrombectomy attempt resulting from unsuccessful sheath placement. Results Patients had a mean age of 69±12 years. The average National Institutes of Health Stroke Scale score was 16±4. Successful revascularization (modified Thrombolysis In Cerebral Infarction 2b-3) rate was 86% (18/21), and 90-day good functional outcome rate (modified Rankin Scale 0–2) was 38% (8/21). Conclusion DCCAP is a rescue alternative for patients with unfavorable access via the transfemoral route. Timely switching to DCCAP is crucial in these cases. |
| first_indexed | 2024-03-08T07:25:13Z |
| format | Article |
| id | doaj.art-6c0201da3505405b9546ec16565a26e1 |
| institution | Directory Open Access Journal |
| issn | 2093-9043 2233-6273 |
| language | English |
| last_indexed | 2024-03-08T07:25:13Z |
| publishDate | 2020-07-01 |
| publisher | Korean Society of Interventional Neuroradiology |
| record_format | Article |
| series | Neurointervention |
| spelling | doaj.art-6c0201da3505405b9546ec16565a26e12024-02-02T22:14:11ZengKorean Society of Interventional NeuroradiologyNeurointervention2093-90432233-62732020-07-01152606610.5469/neuroint.2020.00010284Direct Common Carotid Artery Puncture: Rescue Mechanical Thrombectomy Strategy in Acute Ischemic StrokeCetin Kursad Akpinar0Erdem Gurkas1Ozlem Aykac2Yusuf Inanc3Semih Giray4Atilla Ozcan Ozdemir5 Deparment of Neurology, Samsun Training and Research Hospital, Samsun, Turkey Department of neurology, Lütfi Kırdar Training and Research Hospital, İstanbul, Turkey Department of Neurology, Medical Faculty, Eskisehir Osmangazi University, Eskisehir, Turkey Department of Neurology, Medical Faculty, Gaziantep University, Gaziantep, Turkey Department of Neurology, Medical Faculty, Gaziantep University, Gaziantep, Turkey Department of Neurology, Medical Faculty, Eskisehir Osmangazi University, Eskisehir, TurkeyPurpose In a minority of cases, the transfemoral approach cannot be performed due to unfavorable anatomical barriers. In such cases, direct common carotid artery puncture (DCCAP) is an important alternative for rescue mechanical thrombectomy. The purpose of this study was to evaluate the efficacy and safety of DCCAP in patients with an unaccessible femoral route for mechanical thrombectomy. Materials and Methods This is a retrospective study using data in the Turkish Interventional Neurology Database recorded between January 2015 and April 2019. Twenty-five acute stroke patients treated with DCCAP were analyzed in this study. Among 25 cases with carotid puncture, 4 cases were excluded due to an aborted thrombectomy attempt resulting from unsuccessful sheath placement. Results Patients had a mean age of 69±12 years. The average National Institutes of Health Stroke Scale score was 16±4. Successful revascularization (modified Thrombolysis In Cerebral Infarction 2b-3) rate was 86% (18/21), and 90-day good functional outcome rate (modified Rankin Scale 0–2) was 38% (8/21). Conclusion DCCAP is a rescue alternative for patients with unfavorable access via the transfemoral route. Timely switching to DCCAP is crucial in these cases.http://neurointervention.org/upload/pdf/neuroint-2020-00010.pdfstrokethrombectomytreatment outcomecommon carotid artery |
| spellingShingle | Cetin Kursad Akpinar Erdem Gurkas Ozlem Aykac Yusuf Inanc Semih Giray Atilla Ozcan Ozdemir Direct Common Carotid Artery Puncture: Rescue Mechanical Thrombectomy Strategy in Acute Ischemic Stroke Neurointervention stroke thrombectomy treatment outcome common carotid artery |
| title | Direct Common Carotid Artery Puncture: Rescue Mechanical Thrombectomy Strategy in Acute Ischemic Stroke |
| title_full | Direct Common Carotid Artery Puncture: Rescue Mechanical Thrombectomy Strategy in Acute Ischemic Stroke |
| title_fullStr | Direct Common Carotid Artery Puncture: Rescue Mechanical Thrombectomy Strategy in Acute Ischemic Stroke |
| title_full_unstemmed | Direct Common Carotid Artery Puncture: Rescue Mechanical Thrombectomy Strategy in Acute Ischemic Stroke |
| title_short | Direct Common Carotid Artery Puncture: Rescue Mechanical Thrombectomy Strategy in Acute Ischemic Stroke |
| title_sort | direct common carotid artery puncture rescue mechanical thrombectomy strategy in acute ischemic stroke |
| topic | stroke thrombectomy treatment outcome common carotid artery |
| url | http://neurointervention.org/upload/pdf/neuroint-2020-00010.pdf |
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