Article Text
PDF
Abstract
Background Efficient recanalization of occluded cerebral arteries is crucial in the treatment of acute ischemic stroke. Double stent retrievers have shown the potential to enhance the rates of recanalization on the first pass. This study aims to evaluate the efficacy and safety of the double stent retriever technique and the predictors of achieving first-pass effect in patients with acute ischemic stroke.
Methods This prospective multicenter study involved 209 patients from 16 comprehensive stroke centers in Spain. Patients with occlusions in the anterior circulation were treated using the Aperio Hybrid double stent retriever. The study examined various deployment techniques, including simultaneous and sequential deployment and stent configurations, comparing the Y-shaped and parallel configurations.
Results The double stent retriever technique achieved a first-pass effect in 72.7% of cases and a final successful recanalization rate of 99.5%. The Y-shaped configuration was significantly associated with higher recanalization rates on the first pass (OR 2.59, 95% CI 1.18 to 5.68, P=0.02). Procedural complications were mild to moderate in 6.7% and severe in 1.5% of cases, with symptomatic intracranial hemorrhage occurring in 3.3% of patients. At 3 months follow-up, 57.2% of patients achieved a good clinical outcome, with a mortality rate of 15.1%.
Conclusion The findings support the efficacy of the double stent retriever technique, particularly the Y-shaped configuration, in achieving high recanalization rates on the first pass with an acceptable safety profile. This technique may offer clinical benefits for future acute ischemic stroke treatment protocols.
- Thrombectomy
- Stroke
- Stent
- Artery
- Device
Data availability statement
Data are available upon reasonable request.
Statistics from Altmetric.com
Data availability statement
Data are available upon reasonable request.
Footnotes
X @jesusdvenegasg, @Sremollo, @neuroplumber
Contributors Guarantor: CPG. Protocol/project development: CPG, MM, SR, CGE, ALF. Interventional procedures performance: CPG, MM, SR, ALF, MC, JCL, LV, JLL, JV, EG, JF, MEdR, JZ, SB, TD, CdlR, JCG, FBM, VC, JMMO, JCM, SR, RB, EM. Data collection and management: CPG, MM, SR, ALF, MC, JCL, LV, JLL, JV, EG, JF, MEdR, JZ, SB, TD, CdlR, JCG, FBM, VC, JMMO, JCM, SR, RB, EM, CGE. Manuscript writing/editing: CPG, MM, ALF. Revising the work critically for important intellectual content: CPG, MM, SR, ALF, MC, JCL, LV, JLL, JV, EG, JF, MEdR, JZ, SB, TD, CdlR, JCG, FBM, VC, JMMO, JCM, SR, RB, EM, CGE. Manuscript final approval: CPG, MM, SR, ALF, MC, JCL, LV, JLL, JV, EG, JF, MEdR, JZ, SB, TD, CdlR, JCG, FBM, VC, JMMO, JCM, SR, RB, EM, CGE. Agreement to be accountable for all aspects of the work: CPG, MM, SR, ALF, MC, JCL, LV, JLL, JV, EG, JF, MEdR, JZ, SB, TD, CdlR, JCG, FBM, VC, JMMO, JCM, SR, RB, EM, CGE.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.