Large-bore aspiration catheter selection does not influence reperfusion or outcome after manual aspiration thrombectomy.
catheter
stroke
thrombectomy
Journal
Journal of neurointerventional surgery
ISSN: 1759-8486
Titre abrégé: J Neurointerv Surg
Pays: England
ID NLM: 101517079
Informations de publication
Date de publication:
Jul 2019
Jul 2019
Historique:
received:
04
12
2018
revised:
04
01
2019
accepted:
07
01
2019
pubmed:
9
2
2019
medline:
20
8
2019
entrez:
9
2
2019
Statut:
ppublish
Résumé
Various large-bore catheters can be employed for manual aspiration thrombectomy (MAT); clinical differences are rarely explored. Prospectively collected demographic, angiographic, and clinical data for patients with acute internal carotid artery, middle cerebral artery M1, or basilar occlusions undergoing MAT over 23 months at a comprehensive stroke center were reviewed. We excluded patients in stentriever-based randomized trials/registries. The four most commonly utilized aspiration catheters were analyzed, and multivariate logistic regression analyses were performed to determine the effect of primary aspiration catheter choice on first-pass success, final reperfusion, and modified Rankin Scale (mRS) score at 90 days. Of 464 large vessel thrombectomies, 180 were performed via MAT on the first pass with one of four catheters. First-pass success was achieved in 42% of cases overall; this rate did not differ significantly between catheters: 50% for Sofia, 45% for CAT6, 40% for 0.072 inch Navien, and 36% for ACE68, p=0.67. Final Thrombolysis in Cerebral Infarction 2b or 3 reperfusion was achieved in 94% of cases overall: 97% of cases with CAT6, 95% with Sofia, 92% with Navien, and 92% with ACE68, p=0.70. Mean number of passes for index thrombus (2.0 overall), median procedure time (32 min overall), 90-day good outcome (mRS 0-2, mean 36%), and 90-day mortality (mean 27%) did not differ significantly between patients treated with different initial catheters. Among large-bore aspiration catheters, catheter selection is not an independent predictor of first-pass success, final reperfusion, or clinical outcome.
Identifiants
pubmed: 30733300
pii: neurintsurg-2018-014633
doi: 10.1136/neurintsurg-2018-014633
doi:
Types de publication
Journal Article
Langues
eng
Pagination
637-640Informations de copyright
© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: BTJ: Consultant: Medtronic. MWB: Investor: Penumbra. BAG: Consultant: Microvention. TGJ: Consultant: Stryker Neurovascular (PI DAWN-unpaid); Ownership Interest: Anaconda; Advisory Board/Investor: FreeOx Biotech, Advisory Board/Investor: Route92; Advisory Board/Investor: Blockade Medical, Consultant; Honoraria: Cerenovus.