학술논문
Combined technique as first approach in mechanical thrombectomy: Efficacy and safety of REACT catheter combined with stent retriever.
Document Type
Academic Journal
Author
Requena M; Unitat d'Ictus, Hospital Universitari Vall d'Hebron, Barcelona, Spain.; Neurorradiologia Intervencionista, Hospital Universitari Vall d'Hebron, Barcelona, Spain.; Grup de Recerca en Ictus, Vall d'Hebron Institut de Recerca, Barcelona, Spain.; Piñana C; Neurorradiologia Intervencionista, Hospital Universitari Vall d'Hebron, Barcelona, Spain.; Olive-Gadea M; Unitat d'Ictus, Hospital Universitari Vall d'Hebron, Barcelona, Spain.; Grup de Recerca en Ictus, Vall d'Hebron Institut de Recerca, Barcelona, Spain.; Hernández D; Neurorradiologia Intervencionista, Hospital Universitari Vall d'Hebron, Barcelona, Spain.; Boned S; Unitat d'Ictus, Hospital Universitari Vall d'Hebron, Barcelona, Spain.; Grup de Recerca en Ictus, Vall d'Hebron Institut de Recerca, Barcelona, Spain.; De Dios M; Neurorradiologia Intervencionista, Hospital Universitari Vall d'Hebron, Barcelona, Spain.; Rodrigo M; Unitat d'Ictus, Hospital Universitari Vall d'Hebron, Barcelona, Spain.; Rivera E; Neurorradiologia Intervencionista, Hospital Universitari Vall d'Hebron, Barcelona, Spain.; Grup de Recerca en Ictus, Vall d'Hebron Institut de Recerca, Barcelona, Spain.; Muchada M; Unitat d'Ictus, Hospital Universitari Vall d'Hebron, Barcelona, Spain.; Grup de Recerca en Ictus, Vall d'Hebron Institut de Recerca, Barcelona, Spain.; Cuevas JL; Neurorradiologia Intervencionista, Hospital Universitari Vall d'Hebron, Barcelona, Spain.; Grup de Recerca en Ictus, Vall d'Hebron Institut de Recerca, Barcelona, Spain.; Servicio Neurocirugía, Hospital de Puerto Montt, Puerto Montt, Chile.; Rubiera M; Unitat d'Ictus, Hospital Universitari Vall d'Hebron, Barcelona, Spain.; Grup de Recerca en Ictus, Vall d'Hebron Institut de Recerca, Barcelona, Spain.; García-Tornel Á; Unitat d'Ictus, Hospital Universitari Vall d'Hebron, Barcelona, Spain.; Grup de Recerca en Ictus, Vall d'Hebron Institut de Recerca, Barcelona, Spain.; Gramegna LL; IRCCS Istituto delle Scienze Neurologiche di Bologna, Functional and Molecular Neuroimaging Unit, Bologna, Italy.; Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy.; Molina C; Unitat d'Ictus, Hospital Universitari Vall d'Hebron, Barcelona, Spain.; Grup de Recerca en Ictus, Vall d'Hebron Institut de Recerca, Barcelona, Spain.; Ribo M; Unitat d'Ictus, Hospital Universitari Vall d'Hebron, Barcelona, Spain.; Grup de Recerca en Ictus, Vall d'Hebron Institut de Recerca, Barcelona, Spain.; Tomasello A; Neurorradiologia Intervencionista, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
Source
Publisher: Sage Publications Country of Publication: United States NLM ID: 9602695 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2385-2011 (Electronic) Linking ISSN: 15910199 NLM ISO Abbreviation: Interv Neuroradiol Subsets: MEDLINE
Subject
Language
English
Abstract
Introduction: Mechanical thrombectomy (MT) with combined treatment including both a stent retriever and distal aspiration catheter may improve recanalization rates in patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO). Here, we evaluated the effectiveness and safety of the REACT aspiration catheter used with a stent retriever.
Methods: This prospective study included consecutive adult patients who underwent MT with a combined technique using REACT 68 and/or 71 between June 2020 and July 2021. The primary endpoints were final and first pass mTICI 2b-3 and mTICI 2c-3 recanalization. Analysis was performed after first pass and after each attempt. Secondary safety outcomes included procedural complications, symptomatic intracranial hemorrhage (sICH) at 24 h, in-hospital mortality, and 90-day functional independence (modified Rankin Scale [mRS] 0-2).
Results: A total of 102 patients were included (median age 78; IQR: 73-87; 50.0% female). At baseline, median NIHSS score was 19 (IQR: 11-21), and ASPECTS was 9 (IQR: 8-10). Final mTICI 2b-3 recanalization was achieved in 91 (89.2%) patients and mTICI 2c-3 was achieved in 66 (64.7%). At first pass, mTICI 2b-3 was achieved in 55 (53.9%) patients, and mTICI 2c-3 in 37 (36.3%). The rate of procedural complications was 3.9% (4/102), sICH was 6.8% (7/102), in-hospital mortality was 12.7% (13/102), and 90-day functional independence was 35.6% (36/102).
Conclusion: A combined MT technique using a stent retriever and REACT catheter resulted in a high rate of successful recanalization and first pass recanalization in a sample of consecutive patients with AIS due to LVO in clinical use.
Competing Interests: Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: MRi has modest ownership and serves on the advisory board of Methinks Software; he has a consulting agreement with Medtronic, Stryker, Johnson and Johnson, Perflow Medical, Anaconda Biomed, Apta Targets, Ceronovus, Philips, Sanofi, and Rapid AI. AT has received personal fees from Anaconda Biomed, Balt, Medtronic, Perflow, and Stryker.
Methods: This prospective study included consecutive adult patients who underwent MT with a combined technique using REACT 68 and/or 71 between June 2020 and July 2021. The primary endpoints were final and first pass mTICI 2b-3 and mTICI 2c-3 recanalization. Analysis was performed after first pass and after each attempt. Secondary safety outcomes included procedural complications, symptomatic intracranial hemorrhage (sICH) at 24 h, in-hospital mortality, and 90-day functional independence (modified Rankin Scale [mRS] 0-2).
Results: A total of 102 patients were included (median age 78; IQR: 73-87; 50.0% female). At baseline, median NIHSS score was 19 (IQR: 11-21), and ASPECTS was 9 (IQR: 8-10). Final mTICI 2b-3 recanalization was achieved in 91 (89.2%) patients and mTICI 2c-3 was achieved in 66 (64.7%). At first pass, mTICI 2b-3 was achieved in 55 (53.9%) patients, and mTICI 2c-3 in 37 (36.3%). The rate of procedural complications was 3.9% (4/102), sICH was 6.8% (7/102), in-hospital mortality was 12.7% (13/102), and 90-day functional independence was 35.6% (36/102).
Conclusion: A combined MT technique using a stent retriever and REACT catheter resulted in a high rate of successful recanalization and first pass recanalization in a sample of consecutive patients with AIS due to LVO in clinical use.
Competing Interests: Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: MRi has modest ownership and serves on the advisory board of Methinks Software; he has a consulting agreement with Medtronic, Stryker, Johnson and Johnson, Perflow Medical, Anaconda Biomed, Apta Targets, Ceronovus, Philips, Sanofi, and Rapid AI. AT has received personal fees from Anaconda Biomed, Balt, Medtronic, Perflow, and Stryker.