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Title: Stent Retriever Thrombectomy in Different Thrombus Locations of Anterior Cerebral Circulation

Abstract

BackgroundMechanical thrombectomy (MT) is a safe and efficient treatment for acute ischemic stroke in patients with proximal anterior occlusion and large penumbra. We evaluated the technical and clinical success of MT in relation to the location of the occlusion (internal carotid artery, M1 and M2 segments of the middle cerebral artery).MethodsWe prospectively reviewed 130 patients of whom 105 met the inclusion criteria. Baseline clinical, procedural and imaging variables, technical outcome (TICI, thrombolysis in cerebral infarction), 24 h imaging outcome and three-month clinical outcome (mRS, modified Rankin Scale) were recorded. Differences between the groups were studied with statistical tests according to the type of the variable.ResultsThere were 37, 46 and 22 patients in the internal carotid artery (ICA), M1 and M2 groups, respectively. TICI 2b or 3 was achieved in 92 cases (88 %) with a non-significant trend towards a better recanalization outcome in the ICA and M1 groups. Overall, 57 of the 105 patients (55 %) experienced favorable clinical outcome (mRS ≤ 2) with no significant differences between the groups. Excellent outcome (mRS ≤ 1) was seen in 40 patients (39 %) and there proportionally more patients with excellent outcome in the ICA and M1 groups (ICA: 44 %, M1: 41 %, M2: 23 % of patients, p = 0.22).ConclusionsThere were no statisticallymore » significant differences in the technical or clinical outcomes between the different sites of occlusion (ICA, M1 or M2). There was a non-significant trend towards achieving excellent clinical outcome (3-month mRS ≤ 1) more often and better recanalization results in the two more proximal locations.« less

Authors:
; ; ; ;  [1];  [2]
  1. Tampere University Hospital, Medical Imaging Center (Finland)
  2. Tampere University Hospital, Department of Neurology (Finland)
Publication Date:
OSTI Identifier:
22642484
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 39; Journal Issue: 7; Other Information: Copyright (c) 2016 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOMEDICAL RADIOGRAPHY; CAROTID ARTERIES; CEREBRAL ARTERIES; INCLUSIONS; ISCHEMIA; PATIENTS; REVIEWS

Citation Formats

Protto, Sara, Sillanpää, Niko, E-mail: niko.sillanpaa@pshp.fi, Pienimäki, Juha-Pekka, Matkaselkä, Ira, Seppänen, Janne, and Numminen, Heikki. Stent Retriever Thrombectomy in Different Thrombus Locations of Anterior Cerebral Circulation. United States: N. p., 2016. Web. doi:10.1007/S00270-016-1315-4.
Protto, Sara, Sillanpää, Niko, E-mail: niko.sillanpaa@pshp.fi, Pienimäki, Juha-Pekka, Matkaselkä, Ira, Seppänen, Janne, & Numminen, Heikki. Stent Retriever Thrombectomy in Different Thrombus Locations of Anterior Cerebral Circulation. United States. doi:10.1007/S00270-016-1315-4.
Protto, Sara, Sillanpää, Niko, E-mail: niko.sillanpaa@pshp.fi, Pienimäki, Juha-Pekka, Matkaselkä, Ira, Seppänen, Janne, and Numminen, Heikki. Fri . "Stent Retriever Thrombectomy in Different Thrombus Locations of Anterior Cerebral Circulation". United States. doi:10.1007/S00270-016-1315-4.
@article{osti_22642484,
title = {Stent Retriever Thrombectomy in Different Thrombus Locations of Anterior Cerebral Circulation},
author = {Protto, Sara and Sillanpää, Niko, E-mail: niko.sillanpaa@pshp.fi and Pienimäki, Juha-Pekka and Matkaselkä, Ira and Seppänen, Janne and Numminen, Heikki},
abstractNote = {BackgroundMechanical thrombectomy (MT) is a safe and efficient treatment for acute ischemic stroke in patients with proximal anterior occlusion and large penumbra. We evaluated the technical and clinical success of MT in relation to the location of the occlusion (internal carotid artery, M1 and M2 segments of the middle cerebral artery).MethodsWe prospectively reviewed 130 patients of whom 105 met the inclusion criteria. Baseline clinical, procedural and imaging variables, technical outcome (TICI, thrombolysis in cerebral infarction), 24 h imaging outcome and three-month clinical outcome (mRS, modified Rankin Scale) were recorded. Differences between the groups were studied with statistical tests according to the type of the variable.ResultsThere were 37, 46 and 22 patients in the internal carotid artery (ICA), M1 and M2 groups, respectively. TICI 2b or 3 was achieved in 92 cases (88 %) with a non-significant trend towards a better recanalization outcome in the ICA and M1 groups. Overall, 57 of the 105 patients (55 %) experienced favorable clinical outcome (mRS ≤ 2) with no significant differences between the groups. Excellent outcome (mRS ≤ 1) was seen in 40 patients (39 %) and there proportionally more patients with excellent outcome in the ICA and M1 groups (ICA: 44 %, M1: 41 %, M2: 23 % of patients, p = 0.22).ConclusionsThere were no statistically significant differences in the technical or clinical outcomes between the different sites of occlusion (ICA, M1 or M2). There was a non-significant trend towards achieving excellent clinical outcome (3-month mRS ≤ 1) more often and better recanalization results in the two more proximal locations.},
doi = {10.1007/S00270-016-1315-4},
journal = {Cardiovascular and Interventional Radiology},
number = 7,
volume = 39,
place = {United States},
year = {Fri Jul 15 00:00:00 EDT 2016},
month = {Fri Jul 15 00:00:00 EDT 2016}
}