PT  - JOURNAL ARTICLE
AU  - Maegerlein, Christian
AU  - Mönch, Sebastian
AU  - Boeckh-Behrens, Tobias
AU  - Lehm, Manuel
AU  - Hedderich, Dennis M
AU  - Berndt, Maria Teresa
AU  - Wunderlich, Silke
AU  - Zimmer, Claus
AU  - Kaesmacher, Johannes
AU  - Friedrich, Benjamin
TI  - PROTECT: PRoximal balloon Occlusion TogEther with direCt Thrombus aspiration during stent retriever thrombectomy – evaluation of a double embolic protection approach in endovascular stroke treatment
AID  - 10.1136/neurintsurg-2017-013558
DP  - 2018 Aug 01
TA  - Journal of NeuroInterventional Surgery
PG  - 751--755
VI  - 10
IP  - 8
4099  - http://jnis.bmj.com/content/10/8/751.short
4100  - http://jnis.bmj.com/content/10/8/751.full
SO  - J NeuroIntervent Surg2018 Aug 01; 10
AB  - Purpose Stent retriever-based mechanical thrombectomy (MT) for emergent large vessel occlusions (ELVO) is often complicated by thrombus fragmentation causing distal embolization and embolization to new vascular territories. Well-established embolic protection approaches include proximal flow arrest and distal aspiration techniques during stent retriever maneuvers. Aiming at the reduction of thrombus fragmentation during MT we evaluated a technical approach combining proximal balloon occlusion together with direct thrombus aspiration during MT: the PROTECT technique.Methods We performed a case-control study comparing the PROTECT technique with sole distal aspiration during MT regarding technical and procedural parameters, n=200 patients with ELVO of either the terminus of the internal carotid artery or the proximal middle artery were included.Results PROTECT resulted in a shorter procedure time (29 vs 40 min; P=0.002), in a higher rate of successful recanalizations (100% vs 78%; P=0.001) and a higher rate of complete reperfusions (70% vs 39%; P<0.001) compared with sole distal aspiration during MT.Conclusion The PROTECT technique is a promising new approach to significantly reduce thrombus fragmentation and, hence distal embolization during MT. This safe and efficient technique needs to be validated in larger trials to confirm our results.