Universität zu Köln

Hesse, Amelie Carolina, Behme, Daniel, Kemmling, Andre, Zapf, Antonia, Hokamp, Nils Grosse, Frischmuth, Isabelle, Maier, Ilko, Liman, Jan, Tsogkas, Ioannis, Buhk, Jan-Hendrik, Tran, Julia, Fiehler, Jens, Mpotsaris, Anastasios ORCID: 0000-0002-1275-8164, Schramm, Peter, Berlis, Ansgar, Knauth, Michael and Psychogios, Marios-Nikos (2018). Comparing different thrombectomy techniques in five large-volume centers: a real world' observational study. J. NeuroInterventional Surg., 10 (6). S. 525 - 530. LONDON: BMJ PUBLISHING GROUP. ISSN 1759-8486

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Abstract

Background and purposeThrombectomy has become the standard of care for acute ischaemic stroke due to large vessel occlusion. Aim of this study was to compare the radiological outcomes and time metrics of the various thrombectomy techniques.MethodsIn this retrospective, multicenter study we analysed the data of 450 patients with occlusion of the anterior circulation, treated in five high-volume center from 2013 to 2016. The treatment techniques were divided in three categories: first-pass use of a large-bore aspiration-catheter; first-pass use of a stent-retriever; and primary combined approach (PCA) of an aspiration-catheter and stent-retriever. Primary endpoints were successful reperfusion and groin to reperfusion time. Secondary endpoints were the number of attempts and occurrence of emboli in new territory (ENT). The primary analysis was based on the intention to treat groups (ITT).ResultsThe ITT-analysis showed significantly higher reperfusion rates, with 86% of successful reperfusion in the PCA-group compared with 73% in the aspiration group and 65% in the stent-retriever group. There was no significant difference in groin to reperfusion time regarding the used technique. The secondary analysis showed an impact of the technique on the number of attempts and the occurrence of ENTs. Lowest ENT rates and attempts were reported with the combined approach.ConclusionsThe combined first-pass deployment of a stent-retriever and an aspiration-catheter was the most effective technique for reperfusion of anterior circulation large vessel occlusion. Our results correlate with the latest single-centrere studies, reporting very high reperfusion rates with PCA variations.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hesse, Amelie Carolina UNSPECIFIED UNSPECIFIED UNSPECIFIED Behme, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Kemmling, Andre UNSPECIFIED UNSPECIFIED UNSPECIFIED Zapf, Antonia UNSPECIFIED UNSPECIFIED UNSPECIFIED Hokamp, Nils Grosse UNSPECIFIED UNSPECIFIED UNSPECIFIED Frischmuth, Isabelle UNSPECIFIED UNSPECIFIED UNSPECIFIED Maier, Ilko UNSPECIFIED UNSPECIFIED UNSPECIFIED Liman, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Tsogkas, Ioannis UNSPECIFIED UNSPECIFIED UNSPECIFIED Buhk, Jan-Hendrik UNSPECIFIED UNSPECIFIED UNSPECIFIED Tran, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Fiehler, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Mpotsaris, Anastasios UNSPECIFIED orcid.org/0000-0002-1275-8164 UNSPECIFIED Schramm, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Berlis, Ansgar UNSPECIFIED UNSPECIFIED UNSPECIFIED Knauth, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Psychogios, Marios-Nikos UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-183518
DOI:	10.1136/neurintsurg-2017-013394
Journal or Publication Title:	J. NeuroInterventional Surg.
Volume:	10
Number:	6
Page Range:	S. 525 - 530
Date:	2018
Publisher:	BMJ PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	1759-8486
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ACUTE ISCHEMIC-STROKE; STENT-RETRIEVER THROMBECTOMY; LARGE VESSEL OCCLUSION; 1ST PASS TECHNIQUE; INTRAVENOUS T-PA; ENDOVASCULAR TREATMENT; MECHANICAL THROMBECTOMY; ASPIRATION THROMBECTOMY; IMAGING SELECTION; RANDOMIZED-TRIAL Multiple languages Neuroimaging; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/18351