BACKGROUND AND PURPOSE: We evaluated recanalization rates, clinical outcomes, and safety when manual aspiration thrombectomy is used in conjunction with other thrombolytic modalities in a consecutive case series of patients with large vessel intracranial occlusion. METHODS: We conducted a retrospective review of a prospectively acquired acute endovascular stroke database. Manual aspiration thrombectomy was carried out with Distal Access and Penumbra reperfusion catheters of different sizes placed in the thrombus and aspirated with a syringe. RESULTS: We identified 191 patients: Occlusion locations were as follows: M1% to 50%, M2% to 10%, internal carotid artery terminus 25%, and vertebrobasilar 15%. Median treatment duration was 90 minutes. Recanalization results were Thrombolysis in Myocardial Ischemia 2/3 93%, Thrombolysis in Myocardial Ischemia 3 27%, Thrombolysis In Cerebral Infarction 2a/2b/3 91%, Thrombolysis In Cerebral Infarction 2b/3 71%, and Thrombolysis In Cerebral Infarction 3 25%. Larger catheters were associated with higher recanalization rates. Parenchymal hematoma rate was 13.6%. The favorable outcome (90-day modified Rankin Scale ≤ 2) rate was 54%. Mortality at 90 days was 25%. CONCLUSIONS: Manual aspiration thrombectomy is a useful addition to the armamentarium of endovascular treatment modalities for acute stroke.
BACKGROUND AND PURPOSE: We evaluated recanalization rates, clinical outcomes, and safety when manual aspiration thrombectomy is used in conjunction with other thrombolytic modalities in a consecutive case series of patients with large vessel intracranial occlusion. METHODS: We conducted a retrospective review of a prospectively acquired acute endovascular stroke database. Manual aspiration thrombectomy was carried out with Distal Access and Penumbra reperfusion catheters of different sizes placed in the thrombus and aspirated with a syringe. RESULTS: We identified 191 patients: Occlusion locations were as follows: M1% to 50%, M2% to 10%, internal carotid artery terminus 25%, and vertebrobasilar 15%. Median treatment duration was 90 minutes. Recanalization results were Thrombolysis in Myocardial Ischemia 2/3 93%, Thrombolysis in Myocardial Ischemia 3 27%, Thrombolysis In Cerebral Infarction 2a/2b/3 91%, Thrombolysis In Cerebral Infarction 2b/3 71%, and Thrombolysis In Cerebral Infarction 3 25%. Larger catheters were associated with higher recanalization rates. Parenchymal hematoma rate was 13.6%. The favorable outcome (90-day modified Rankin Scale ≤ 2) rate was 54%. Mortality at 90 days was 25%. CONCLUSIONS: Manual aspiration thrombectomy is a useful addition to the armamentarium of endovascular treatment modalities for acute stroke.
Authors: S Prothmann; B Friedrich; T Boeckh-Behrens; C Zimmer; J Kaesmacher; K Lucia; C Maegerlein Journal: Clin Neuroradiol Date: 2017-01-12 Impact factor: 3.649
Authors: Francesco Massari; Nils Henninger; Juan Diego Lozano; Anand Patel; Anna Luisa Kuhn; Mary Howk; Mary Perras; Christopher Brooks; Matthew J Gounis; Peter Kan; Ajay K Wakhloo; Ajit S Puri Journal: Interv Neuroradiol Date: 2016-02-22 Impact factor: 1.610
Authors: D O'Neill; E Griffin; K M Doyle; S Power; P Brennan; M Sheehan; A O'Hare; S Looby; A M da Silva Santos; R Rossi; J Thornton Journal: AJNR Am J Neuroradiol Date: 2019-07-18 Impact factor: 3.825
Authors: Ashutosh P Jadhav; Amin Aghaebrahim; Anat Horev; Dan-Victor Giurgiutiu; Andrew F Ducruet; Brian Jankowitz; Tudor G Jovin Journal: Interv Neurol Date: 2016-10-07