Cetin Kursad Akpinar1, Erdem Gurkas2, Ozlem Aykac3, Yusuf Inanc4, Semih Giray4, Atilla Ozcan Ozdemir3. 1. Deparment of Neurology, Samsun Training and Research Hospital, Samsun, Turkey. 2. Department of neurology, Lütfi Kırdar Training and Research Hospital, İstanbul, Turkey. 3. Department of Neurology, Medical Faculty, Eskisehir Osmangazi University, Eskisehir, Turkey. 4. Department of Neurology, Medical Faculty, Gaziantep University, Gaziantep, Turkey.
Abstract
PURPOSE: In a minority of cases, the transfemoral approach cannot be performed due to unfavorable anatomical barriers. In such cases, direct common carotid artery puncture (DCCAP) is an important alternative for rescue mechanical thrombectomy. The purpose of this study was to evaluate the efficacy and safety of DCCAP in patients with an unaccessible femoral route for mechanical thrombectomy. MATERIALS AND METHODS: This is a retrospective study using data in the Turkish Interventional Neurology Database recorded between January 2015 and April 2019. Twenty-five acute stroke patients treated with DCCAP were analyzed in this study. Among 25 cases with carotid puncture, 4 cases were excluded due to an aborted thrombectomy attempt resulting from unsuccessful sheath placement. RESULTS: Patients had a mean age of 69±12 years. The average National Institutes of Health Stroke Scale score was 16±4. Successful revascularization (modified Thrombolysis In Cerebral Infarction 2b-3) rate was 86% (18/21), and 90-day good functional outcome rate (modified Rankin Scale 0-2) was 38% (8/21). CONCLUSION: DCCAP is a rescue alternative for patients with unfavorable access via the transfemoral route. Timely switching to DCCAP is crucial in these cases.
PURPOSE: In a minority of cases, the transfemoral approach cannot be performed due to unfavorable anatomical barriers. In such cases, direct common carotid artery puncture (DCCAP) is an important alternative for rescue mechanical thrombectomy. The purpose of this study was to evaluate the efficacy and safety of DCCAP in patients with an unaccessible femoral route for mechanical thrombectomy. MATERIALS AND METHODS: This is a retrospective study using data in the Turkish Interventional Neurology Database recorded between January 2015 and April 2019. Twenty-five acute strokepatients treated with DCCAP were analyzed in this study. Among 25 cases with carotid puncture, 4 cases were excluded due to an aborted thrombectomy attempt resulting from unsuccessful sheath placement. RESULTS:Patients had a mean age of 69±12 years. The average National Institutes of Health Stroke Scale score was 16±4. Successful revascularization (modified Thrombolysis In Cerebral Infarction 2b-3) rate was 86% (18/21), and 90-day good functional outcome rate (modified Rankin Scale 0-2) was 38% (8/21). CONCLUSION:DCCAP is a rescue alternative for patients with unfavorable access via the transfemoral route. Timely switching to DCCAP is crucial in these cases.
Entities:
Keywords:
Common carotid artery; Stroke; Thrombectomy; Treatment outcome