Thrombectomy with embed aspiration in acute ischaemic stroke.

Aspiration technique Ictus Stroke Thrombectomy Trombectomía Técnica de aspiración

Journal

Neurologia
ISSN: 2173-5808
Titre abrégé: Neurologia (Engl Ed)
Pays: Spain
ID NLM: 101778590

Informations de publication

Date de publication:
26 Apr 2023
Historique:
received: 16 05 2021
accepted: 24 09 2021
pubmed: 29 4 2023
medline: 29 4 2023
entrez: 28 4 2023
Statut: aheadofprint

Résumé

In addition to stent retrievers, direct aspiration has become a reasonable thrombectomy strategy. We carried out the thrombectomy by guiding the aspiration catheter fully over the clot and performing immediate manual aspiration; we call this procedure "embed aspiration". In this prospective, non-randomised, single-centre study, we included all patients treated at a high volume-of-care stroke centre between 2017 and 2018 for the TRIANA (Thrombectomy in Andalusia using Aspiration) registry. Thrombectomy was carried out by embed aspiration. Patients were classified according to the success (eTICI 2b67-2c-3) or failure (eTICI 0-1-2a-2b50) of the procedure. Baseline clinical data and outcomes were compared, and multivariate analysis was performed. The embed aspiration technique was used in 370 patients. Treatment was successful in 90.3% of patients. Mean puncture-to-recanalisation time was 25 minutes. The overall rate of good outcomes (mRS 0-2) at 3 months was 64%. This study supports real-life evidence that standardised embed aspiration may be an alternative to stent retrievers for thrombectomy.

Sections du résumé

BACKGROUND BACKGROUND
In addition to stent retrievers, direct aspiration has become a reasonable thrombectomy strategy.
OBJECTIVES OBJECTIVE
We carried out the thrombectomy by guiding the aspiration catheter fully over the clot and performing immediate manual aspiration; we call this procedure "embed aspiration".
METHODS METHODS
In this prospective, non-randomised, single-centre study, we included all patients treated at a high volume-of-care stroke centre between 2017 and 2018 for the TRIANA (Thrombectomy in Andalusia using Aspiration) registry. Thrombectomy was carried out by embed aspiration. Patients were classified according to the success (eTICI 2b67-2c-3) or failure (eTICI 0-1-2a-2b50) of the procedure. Baseline clinical data and outcomes were compared, and multivariate analysis was performed.
RESULTS RESULTS
The embed aspiration technique was used in 370 patients. Treatment was successful in 90.3% of patients. Mean puncture-to-recanalisation time was 25 minutes. The overall rate of good outcomes (mRS 0-2) at 3 months was 64%.
CONCLUSIONS CONCLUSIONS
This study supports real-life evidence that standardised embed aspiration may be an alternative to stent retrievers for thrombectomy.

Identifiants

pubmed: 37116689
pii: S2173-5808(23)00030-5
doi: 10.1016/j.nrleng.2021.09.013
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2021 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

Auteurs

A de Albóniga-Chindurza (A)

Unidad de Neurorradiología Intervencionista, Servicio de Radiología, Hospital Universitario Virgen del Rocío, Sevilla, Spain; Laboratorio de Investigación Neurovascular, Instituto de Biomedicina de Sevilla (IBiS), Sevilla, Spain.

J Ortega-Quintanilla (J)

Unidad de Neurorradiología Intervencionista, Servicio de Radiología, Hospital Universitario Virgen del Rocío, Sevilla, Spain.

F Moniche (F)

Laboratorio de Investigación Neurovascular, Instituto de Biomedicina de Sevilla (IBiS), Sevilla, Spain; Servicio de Neurología, Hospital Universitario Virgen del Rocío, Sevilla, Spain.

L San Román (L)

Laboratorio Central Angiográfico, Unidad de Neurorradiología Intervencionista, Servicio de Radiología, Hospital Universitario Clínic de Barcelona, Barcelona, Spain.

E Zapata-Arriaza (E)

Unidad de Neurorradiología Intervencionista, Servicio de Radiología, Hospital Universitario Virgen del Rocío, Sevilla, Spain; Laboratorio de Investigación Neurovascular, Instituto de Biomedicina de Sevilla (IBiS), Sevilla, Spain.

I Escudero-Martínez (I)

Laboratorio de Investigación Neurovascular, Instituto de Biomedicina de Sevilla (IBiS), Sevilla, Spain; Servicio de Neurología, Hospital Universitario Virgen del Rocío, Sevilla, Spain.

M Zapata (M)

Laboratorio de Investigación Neurovascular, Instituto de Biomedicina de Sevilla (IBiS), Sevilla, Spain.

S Pérez-Sánchez (S)

Laboratorio de Investigación Neurovascular, Instituto de Biomedicina de Sevilla (IBiS), Sevilla, Spain; Servicio de Neurología, Hospital Universitario Virgen Macarena, Sevilla, Spain.

M A Gamero (MA)

Servicio de Neurología, Hospital Universitario Virgen Macarena, Sevilla, Spain.

A Barragán-Prieto (A)

Servicio de Neurología, Hospital Universitario Virgen Macarena, Sevilla, Spain.

L Lebrato (L)

Laboratorio de Investigación Neurovascular, Instituto de Biomedicina de Sevilla (IBiS), Sevilla, Spain; Servicio de Neurología, Hospital Universitario Virgen del Rocío, Sevilla, Spain.

B Pardo-Galiana (B)

Laboratorio de Investigación Neurovascular, Instituto de Biomedicina de Sevilla (IBiS), Sevilla, Spain; Servicio de Neurología, Hospital Universitario Virgen del Rocío, Sevilla, Spain.

J A Cabezas (JA)

Laboratorio de Investigación Neurovascular, Instituto de Biomedicina de Sevilla (IBiS), Sevilla, Spain; Servicio de Neurología, Hospital Universitario Virgen del Rocío, Sevilla, Spain.

L Ainz (L)

Servicio de Neurología, Hospital Universitario Virgen del Rocío, Sevilla, Spain.

A Cayuela (A)

Unidad de Gestión Clínica de Salud Pública, Prevención y Promoción de la Salud, Hospital de Valme, Área de Gestión Sanitaria Sur de Sevilla, Sevilla, Spain.

J Montaner (J)

Laboratorio de Investigación Neurovascular, Instituto de Biomedicina de Sevilla (IBiS), Sevilla, Spain; Servicio de Neurología, Hospital Universitario Virgen Macarena, Sevilla, Spain.

A González (A)

Unidad de Neurorradiología Intervencionista, Servicio de Radiología, Hospital Universitario Virgen del Rocío, Sevilla, Spain; Laboratorio de Investigación Neurovascular, Instituto de Biomedicina de Sevilla (IBiS), Sevilla, Spain. Electronic address: ggjandro@gmail.com.

Classifications MeSH