Endovascular stroke treatment now and then-procedural and clinical effectiveness and safety of different mechanical thrombectomy techniques over time
Von Gadow N, Nikoubashman O, Freiherr J, Block F, Reich A, Fesl G, Wiesmann M (2017)
Publication Status: Published
Publication Type: Journal article
Publication year: 2017
Journal
Publisher: AME PUBL CO
Book Volume: 7
Pages Range: 1-7
Journal Issue: 1
Abstract
Background: The most essential development in endovascular stroke treatment (EST) was the shift from intra-arterial thrombolysis to endovascular thrombectomy with dedicated thrombectomy devices, most notably the introduction of stent-retrievers. We evaluated procedural and clinical effectiveness and safety of different EST techniques over time.Methods: We retrospectively analyzed EST cases that were treated by the same interventionalist before (n=36) and after (n=50) stent-retrievers were established as the treatment device of first choice. EST techniques in the first cohort comprised intra-arterial thrombolysis (n=24), manual thrombus aspiration (n=15), the use of the Penumbra thrombectomy system (n=13) and the Phenox clot retriever (n=3), intracranial stenting (n=10), and EST with stent-retrievers as a salvage procedure (n=11). In the second cohort, EST with stent-retrievers was the treatment option of first choice (n=47). Intra-arterial thrombolysis (n=15) and stenting of the occluded vessel (n=1) were performed, whenever EST with stent-retrievers failed.Results: In both cohorts, revascularization rates (TICI =2b) were high (91.7% and 86.0%, respectively). A significantly lower number of interventional techniques per case were required in the second cohort (mean +/- SD, 1.4 +/- 0.5 vs. 2.1 +/- 0.9, P<0.001). Recanalization was achieved almost twice as fast in the second cohort (85 vs. 163 minutes on average, P<0.001). The rate of patients achieving good functional outcome (mRS =2) was higher in the second cohort (40.0% vs. 22.2%, P=0.083).Conclusions: Our findings imply that when stent-retrievers were established as first-line the treatment device a significantly lower number of interventional techniques per case were required and recanalization was achieved almost twice as fast.
Authors with CRIS profile
Involved external institutions
Universitätsklinikum Aachen (UKA)
Germany (DE)
Ludwig-Maximilians-Universität (LMU)
Germany (DE)
HELIOS Kliniken
Germany (DE)
Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen
Germany (DE)
Germany (DE)
Ludwig-Maximilians-Universität (LMU)
Germany (DE)
HELIOS Kliniken
Germany (DE)
Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen
Germany (DE)
How to cite
APA:
Von Gadow, N., Nikoubashman, O., Freiherr, J., Block, F., Reich, A., Fesl, G., & Wiesmann, M. (2017). Endovascular stroke treatment now and then-procedural and clinical effectiveness and safety of different mechanical thrombectomy techniques over time. Quantitative Imaging in Medicine and Surgery, 7(1), 1-7. https://doi.org/10.21037/qims.2017.02.06
MLA:
Von Gadow, Niels, et al. "Endovascular stroke treatment now and then-procedural and clinical effectiveness and safety of different mechanical thrombectomy techniques over time." Quantitative Imaging in Medicine and Surgery 7.1 (2017): 1-7.
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