The SAVE Technique : Large-Scale Experience for Treatment of Intracranial Large Vessel Occlusions.
Aged
Aged, 80 and over
Arterial Occlusive Diseases
/ diagnostic imaging
Carotid Artery, Internal
/ diagnostic imaging
Carotid Stenosis
/ diagnostic imaging
Cerebral Angiography
Endovascular Procedures
/ methods
Female
Humans
Male
Reperfusion
/ methods
Retrospective Studies
Stroke
/ diagnostic imaging
Thrombectomy
/ methods
Thrombolytic Therapy
/ methods
Treatment Outcome
Ischemic stroke
Large vessel occlusion
Mechanical thrombectomy
SAVE
Stent-retriever
Journal
Clinical neuroradiology
ISSN: 1869-1447
Titre abrégé: Clin Neuroradiol
Pays: Germany
ID NLM: 101526693
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
received:
29
03
2018
accepted:
12
06
2018
pubmed:
22
7
2018
medline:
21
4
2020
entrez:
21
7
2018
Statut:
ppublish
Résumé
The stent retriever assisted vacuum-locked extraction (SAVE) technique was introduced as an effective thrombectomy method in stroke patients suffering from intracranial large vessel occlusion (LVO). This article presents our multicenter, large-scale experience with SAVE. The study involved a retrospective core team analysis of 200 patients undergoing mechanical thrombectomy using the SAVE technique due to intracranial LVO at 4 German centers. Primary endpoints were first-pass and overall complete/near complete reperfusion, defined as a modified thrombolysis in cerebral infarction (mTICI) score of 2c and 3. Secondary endpoints were the number of passes, time from groin puncture to reperfusion, embolization to new territories (ENT), postinterventional symptomatic intracranial hemorrhage (sICH), and favorable outcome at discharge, defined as a modified Rankin Scale (mRS) score ≤ 2. The median age was 78 years (interquartile range IQR 68-85). Median National Institutes of Health stroke scale (NIHSS) at admission was 16 (IQR 12-20). Occlusions sites were: internal carotid artery (ICA-T) in 39/200 (19.5%), M1 in 126/200 (63%), M2 in 30/200 (15%), and others in 5/200 (2.5%) cases. The primary endpoints were documented in 114/200 (57% first pass mTICI 2c or 3) and 154/200 (77% overall mTICI 2c or 3) patients, respectively. The overall median time from groin puncture to reperfusion was 34 min (IQR 25-52) with a median of 1 (IQR 1-2) attempts. An ENT was observed in 3 patients (1.5%) and the rate of sICH was 2.6%. The rate of successful reperfusion (mTICI ≥ 2b) on final angiograms was 95%. At discharge, 73/200 (36.5%) patients revealed a favorable outcome. Mechanical thrombectomy using the SAVE technique seems to be effective, fast and safe. First-line use of SAVE leads to high rates of complete and near complete reperfusion.
Sections du résumé
BACKGROUND
BACKGROUND
The stent retriever assisted vacuum-locked extraction (SAVE) technique was introduced as an effective thrombectomy method in stroke patients suffering from intracranial large vessel occlusion (LVO). This article presents our multicenter, large-scale experience with SAVE.
METHODS
METHODS
The study involved a retrospective core team analysis of 200 patients undergoing mechanical thrombectomy using the SAVE technique due to intracranial LVO at 4 German centers. Primary endpoints were first-pass and overall complete/near complete reperfusion, defined as a modified thrombolysis in cerebral infarction (mTICI) score of 2c and 3. Secondary endpoints were the number of passes, time from groin puncture to reperfusion, embolization to new territories (ENT), postinterventional symptomatic intracranial hemorrhage (sICH), and favorable outcome at discharge, defined as a modified Rankin Scale (mRS) score ≤ 2.
RESULTS
RESULTS
The median age was 78 years (interquartile range IQR 68-85). Median National Institutes of Health stroke scale (NIHSS) at admission was 16 (IQR 12-20). Occlusions sites were: internal carotid artery (ICA-T) in 39/200 (19.5%), M1 in 126/200 (63%), M2 in 30/200 (15%), and others in 5/200 (2.5%) cases. The primary endpoints were documented in 114/200 (57% first pass mTICI 2c or 3) and 154/200 (77% overall mTICI 2c or 3) patients, respectively. The overall median time from groin puncture to reperfusion was 34 min (IQR 25-52) with a median of 1 (IQR 1-2) attempts. An ENT was observed in 3 patients (1.5%) and the rate of sICH was 2.6%. The rate of successful reperfusion (mTICI ≥ 2b) on final angiograms was 95%. At discharge, 73/200 (36.5%) patients revealed a favorable outcome.
CONCLUSION
CONCLUSIONS
Mechanical thrombectomy using the SAVE technique seems to be effective, fast and safe. First-line use of SAVE leads to high rates of complete and near complete reperfusion.
Identifiants
pubmed: 30027326
doi: 10.1007/s00062-018-0702-4
pii: 10.1007/s00062-018-0702-4
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
669-676Références
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