Aspiration Catheter Reach to Thrombus (ART) Sign in Combined Technique for Mechanical Thrombectomy: Impact for First-Pass Complete Reperfusion

Mizokami, Taichiro; Uwatoko, Takeshi; Matsumoto, K.; Ooya, Yuichiro; Hashimoto, Go; Koguchi, Motofumi; Iwashita, Hideki; Uwatoko, Kiku; Takashima, Hiroshi; Sugimori, Hiroshi; Sakata, Syuji

doi:10.1016/j.jstrokecerebrovasdis.2019.07.017

Cited by 5 publications

(8 citation statements)

References 19 publications

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“…This evaluation would have necessitated systematic contrast-enhanced MRA or a double-injection technique during DSA. Third, only 1 thrombectomy setup was evaluated (the combined technique); [11][12][13] thus, our results cannot translate to other techniques such as direct aspiration. Also, balloon-guided catheter use was left to the operator's discretion and was rarely used in this study (7.4% of the patients).…”

Section: Discussionmentioning

confidence: 97%

“…Treatment with an aspiration 1 stent retriever technique (see "Thrombectomy Techniques"). [11][12][13] During the study period, mechanical thrombectomy was provided regardless of age, baseline NIHSS severity, or infarct size. Patients experienced either fast or slow stent retrieval (and a distal aspiration catheter), depending on the operator's discretion.…”

Section: Study Settingmentioning

confidence: 99%

“…All patients were treated with a combined technique, [11][12][13] aiming to wedge the thrombus between a stent retriever (Solitaire 2/ Platinum; Medtronic) and an aspiration distal catheter (ACE 64/ 68, Penumbra; Sofia Plus, MicroVention) connected to a pump or a syringe. The use of a balloon-guide catheter was optional.…”

Section: Thrombectomy Techniquesmentioning

confidence: 99%

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Fast Stent Retrieval during Mechanical Thrombectomy Improves Recanalization in Patients with the Negative Susceptibility Vessel Sign

Soize

Eymard

Cheikhrouhou

et al. 2021

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:In acute ischemic stroke, the negative susceptibility vessel sign on T2*-weighted images traditionally highlights fibrin-rich clots, which are particularly challenging to remove. In vitro, fast stent retrieval improves fibrin-rich clot extraction. We aimed to evaluate whether the speed of stent retrieval influences the recanalization and clinical outcome of patients presenting with the negative susceptibility vessel sign.

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Section: Discussionmentioning

confidence: 97%

Section: Study Settingmentioning

confidence: 99%

See 1 more Smart Citation

Fast Stent Retrieval during Mechanical Thrombectomy Improves Recanalization in Patients with the Negative Susceptibility Vessel Sign

Soize

Eymard

Cheikhrouhou

et al. 2021

AJNR Am J Neuroradiol

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“…Currently, the development of various thrombectomy tech-niques has enhanced the clinical and radiologic outcomes of patients with LAO 6,7,19) . Recent advances in MT pursuit the first pass effect (first-pass reperfusion or first-pass complete reperfusion), beyond simple successful recanalization 25) . The importance of the first-pass effect has been reported in various studies, where it was associated with a significantly higher chance of favorable clinical outcomes with the retrieval of the entire thrombus as a single mass on the first attempt 23,24,34) .…”

Section: Discussionmentioning

confidence: 99%

“…Fewer stent passages reduced the risk of procedure-related complications, such as parenchymal hematoma and other vessel damage 3) . Therefore, the utility of the Solumbra technique contributes to reperfusion or complete reperfusion from the first pass 14,21,25) . Based on these studies, the authors used Solumbra technique for MT in most cases.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and Technical Considerations of Solitaire Platinum 4×40 mm Stent Retriever in Mechanical Thrombectomy with Solumbra Technique

Sung

Lee

et al. 2021

J Korean Neurosurg Soc

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Objective : The Solitaire Platinum 4×40 mm stent retriever contains radiopaque markers with a long length. We evaluated the effect of Solitaire Platinum 4×40 mm stent retriever in Solumbra technique thrombectomy, and compared it with shorter Solitaire stent retrievers. Methods : A total of 70 patients who underwent Solumbra technique thrombectomy with equal diameter (4 mm) and different length (40 vs. 20 mm) Solitaire stent retrievers were divided into two groups : the Solitaire Platinum 4×40 mm stent (4×40) group and the Solitaire FR 4×20 mm stent or Solitaire Platinum 4×20 mm stent (4×20) group. The clinical outcomes, Thrombolysis in Cerebral Infarction score, the first pass reperfusion status, and complications were evaluated and compared between the two groups. Multivariate analysis was performed to evaluate the predictive factors for reperfusion and complete reperfusion from the first pass. Results : Higher first-pass reperfusion and complete reperfusion were achieved in the 4×40 group (68.0% and 48.0%) than in the 4×20 group (46.7% and 33.3%; p=0.004 and 0.007, respectively). In multivariate analysis, radiopaque device and longer stent retriever were correlated with first-pass reperfusion (p=0.014 and 0.008, respectively) and first-pass complete reperfusion (p=0.022 and 0.012, respectively). Conclusion : Our study demonstrated the usefulness of the Solitaire Platinum 4×40 mm stent retriever, which led to higher firstpass reperfusion and complete reperfusion rates than the Solitaire FR 4×20 mm stent or the Solitaire Platinum 4×20 mm stent, especially in Solumbra technique thrombectomy.

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Impact of the position of the aspiration catheter to the first pass effect during the combined technique

Kitamura

Koyanagi

Ogura

et al. 2022

Clinical Neurology and Neurosurgery

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Aspiration Catheter Reach to Thrombus (ART) Sign in Combined Technique for Mechanical Thrombectomy: Impact for First-Pass Complete Reperfusion

Cited by 5 publications

References 19 publications

Fast Stent Retrieval during Mechanical Thrombectomy Improves Recanalization in Patients with the Negative Susceptibility Vessel Sign

Fast Stent Retrieval during Mechanical Thrombectomy Improves Recanalization in Patients with the Negative Susceptibility Vessel Sign

Effectiveness and Technical Considerations of Solitaire Platinum 4×40 mm Stent Retriever in Mechanical Thrombectomy with Solumbra Technique

Impact of the position of the aspiration catheter to the first pass effect during the combined technique

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