RT Journal Article
SR Electronic
T1 Efficacy of combined use of a stent retriever and aspiration catheter in mechanical thrombectomy for acute ischemic stroke
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP neurintsurg-2021-017837
DO 10.1136/neurintsurg-2021-017837
A1 Tomohiro Okuda
A1 Koichi Arimura
A1 Ryu Matsuo
A1 So Tokunaga
A1 Kenta Hara
A1 Shinya Yamaguchi
A1 Hidenori Yoshida
A1 Ryota Kurogi
A1 Katsuharu Kameda
A1 Osamu Ito
A1 Tomoyuki Tsumoto
A1 Koji Iihara
A1 Taichiro Mizokami
A1 Takeshi Uwatoko
A1 Ataru Nishimura
A1 Katsuma Iwaki
A1 Masahiro Mizoguchi
A1 ,
YR 2021
UL http://jnis.bmj.com/content/early/2021/09/20/neurintsurg-2021-017837.abstract
AB Background The efficacy of combined stent retriever (SR) and aspiration catheter (AC; combined technique: CBT) use for acute ischemic stroke (AIS) is unclear. We investigated the safety and efficacy of single-unit CBT (SCBT)—retrieving the thrombus as a single unit with SR and AC into the guide catheter—compared with single use of either SR or contact aspiration (CA).Methods We analysed 763 consecutive patients who underwent mechanical thrombectomy for AIS between January 2013 and January 2020, at six comprehensive stroke centers. Patients were divided into SCBT and single device (SR/CA) groups. The successful recanalization with first pass (SRFP) and other procedural outcomes were compared between groups.Results Overall, 240 SCBT and 301 SR/CA (SR 128, CA 173) patients were analyzed. SRFP (modified Thrombolysis In Cerebral Infarction (mTICI) ≥2c, 43.3% vs 27.9%, p<0.001; mTICI 3, 35.8% vs 25.5%, p=0.009) and final mTICI ≥2b recanalization (89.1% vs 82.0%, p=0.020) rates were significantly higher, puncture-to-reperfusion time was shorter (median (IQR) 43 (31.5–69) vs 55 (38–82.2) min, p<0.001), and the number of passes were fewer (mean±SD 1.72±0.92 vs 1.99±1.01, p<0.001) in the SCBT group. Procedural complications were similar between the groups. In subgroup analysis, SCBT was more effective in women, cardioembolic stroke patients, and internal carotid artery and M2 occlusions.Conclusions SCBT increases the SRFP rate and shortens the puncture-to-reperfusion time without increasing procedural complications.Data are available upon reasonable request.