Clot reduction prior to embolectomy: mSAVE as a first-line technique for large clots.
PLoS One
; 14(5): e0216258, 2019.
Article
em En
| MEDLINE
| ID: mdl-31071109
ABSTRACT
INTRODUCTION:
The "Stent retriever Assisted Vacuum-locked Extraction" (SAVE) technique is a promising embolectomy method for intracranial large vessel occlusion (LVO). We report our experience using a modified SAVE (mSAVE) approach for clot reduction prior to embolectomy in acute ischemic stroke patients with large clots. MATERIALS ANDMETHODS:
We retrospectively analyzed 20 consecutive patients undergoing mSAVE in our center due to intracranial LVO. Angiographic data (including first-pass and overall complete reperfusion, defined as an expanded Thrombolysis in Cerebral Infarction (eTICI) score of 3, rate of successful reperfusion (eTICI ≥2c), number of passes, time from groin puncture to reperfusion) and clinical data (favorable outcome at 90 days, defined as modified Rankin Scale (mRS) ≤2) were assessed.RESULTS:
First-pass and overall eTICI 3 reperfusion was reached in 13/20 (65%) and 14/20 (70%), respectively. The rate of successful reperfusion (eTICI ≥2c) after one pass was 85% and on final angiogram 90% with an average number of 1.1 ± 0.3 attempts. Eight out of 11 (73%) ICA occlusions were reperfused successfully and 5 (46%) completely after a single pass. Median groin to reperfusion time was 33 minutes (IQR 25-46). A favorable clinical outcome was achieved in 9/20 (45%) patients at discharge and after 90 days, respectively.CONCLUSION:
Clot reduction followed by embolectomy (mSAVE) is feasible and may be an important tool in the treatment of large clots.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Angiografia Cerebral
/
Isquemia Encefálica
/
Trombectomia
/
Embolectomia
/
Acidente Vascular Cerebral
/
Procedimentos Endovasculares
Tipo de estudo:
Observational_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
PLoS One
Assunto da revista:
CIENCIA
/
MEDICINA
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Alemanha