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...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-06-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.925159/full |
| _version_ | 1811238009116295168 |
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| author | David Hernández Elena Serrano Gemma Molins Federico Zarco Oscar Chirife Mariano Werner Blanca Lara Anna Ramos Laura Llull Manuel Requena Marta de Dios las Cuevas Sebastián Remollo Carlos Piñana Antonio López-Rueda |
| author_facet | David Hernández Elena Serrano Gemma Molins Federico Zarco Oscar Chirife Mariano Werner Blanca Lara Anna Ramos Laura Llull Manuel Requena Marta de Dios las Cuevas Sebastián Remollo Carlos Piñana Antonio López-Rueda |
| author_sort | David Hernández |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-04-12T12:34:22Z |
| format | Article |
| id | doaj.art-96d545d0c9d0450494094480f8abbfc9 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-12T12:34:22Z |
| publishDate | 2022-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-96d545d0c9d0450494094480f8abbfc92022-12-22T03:32:56ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-06-011310.3389/fneur.2022.925159925159Comparison of First-Pass Effect in Aspiration vs. Stent-Retriever for Acute Intracranial ICA OcclusionDavid Hernández0Elena Serrano1Gemma Molins2Federico Zarco3Oscar Chirife4Mariano Werner5Blanca Lara6Anna Ramos7Laura Llull8Manuel Requena9Marta de Dios las Cuevas10Sebastián Remollo11Carlos Piñana12Antonio López-Rueda13Hospital Universitario Valle de Hebrón, Barcelona, SpainHospital Clínic de Barcelona, Barcelona, SpainInstitute for Medical Engineering and Science (IMES), Massachusetts Institute of Technology (MIT), Cambridge, MA, United StatesHospital Clínic de Barcelona, Barcelona, SpainHospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, SpainHospital Universitario Germans Trias i Pujol, Barcelona, SpainHospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, SpainHospital Universitario Germans Trias i Pujol, Barcelona, SpainHospital Clínic de Barcelona, Barcelona, SpainHospital Universitario Valle de Hebrón, Barcelona, SpainHospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, SpainHospital Universitario Germans Trias i Pujol, Barcelona, SpainHospital Universitario Valle de Hebrón, Barcelona, SpainHospital Clínic de Barcelona, Barcelona, SpainThe 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.https://www.frontiersin.org/articles/10.3389/fneur.2022.925159/fullstent retrieverthrombectomyinternal carotid artery occlusionrevascularizationendovascular |
| spellingShingle | David Hernández Elena Serrano Gemma Molins Federico Zarco Oscar Chirife Mariano Werner Blanca Lara Anna Ramos Laura Llull Manuel Requena Marta de Dios las Cuevas Sebastián Remollo Carlos Piñana Antonio López-Rueda Comparison of First-Pass Effect in Aspiration vs. Stent-Retriever for Acute Intracranial ICA Occlusion Frontiers in Neurology stent retriever thrombectomy internal carotid artery occlusion revascularization endovascular |
| 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 | stent retriever thrombectomy internal carotid artery occlusion revascularization endovascular |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.925159/full |
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