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Defining the optimal size of an aspiration catheter in relation to the arterial diameter during mechanical thrombectomy for stroke.
Charbonnier, Guillaume; Primikiris, Panagiotis; Desmarets, Maxime; Tio, Gregory; Vancheri, Sergio; Di Caterino, Fortunato; Vitale, Giovanni; Biondi, Alessandra.
Afiliação
  • Charbonnier G; Department of Interventional Neuroradiology, Besançon University Hospital, Besançon, France; Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive - UR 481, Université de Franche-Comté, Besançon, France. Electronic address: guillaume.charbonnier@univ-fcomte.fr.
  • Primikiris P; Department of Interventional Neuroradiology, Besançon University Hospital, Besançon, France.
  • Desmarets M; Inserm CIC 1431, CHU Besançon, Unité de méthodologie, Besançon, France; UMR 1098 Right, Inserm, Établissement Français du Sang, Université Bourgogne-Franche-Comté, Besançon, France.
  • Tio G; Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive - UR 481, Université de Franche-Comté, Besançon, France; Inserm CIC 1431, CHU Besançon, Unité de méthodologie, Besançon, France.
  • Vancheri S; Department of Interventional Neuroradiology, Besançon University Hospital, Besançon, France.
  • Di Caterino F; Department of Interventional Neuroradiology, Besançon University Hospital, Besançon, France.
  • Vitale G; Department of Interventional Neuroradiology, Besançon University Hospital, Besançon, France.
  • Biondi A; Department of Interventional Neuroradiology, Besançon University Hospital, Besançon, France; Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive - UR 481, Université de Franche-Comté, Besançon, France.
J Neuroradiol ; 51(1): 47-51, 2024 Feb.
Article em En | MEDLINE | ID: mdl-36738989
BACKGROUND: Mechanical thrombectomy for acute ischemic stroke is effective and includes different technical approaches. Operators use direct aspiration, a stent retriever, or a combination of both. Direct aspiration can be performed with various catheters of different sizes depending on the diameter of the occluded vessel. PURPOSE: We studied the relationship between the catheter diameter in regards to the occluded vessel diameter and the rate of successful recanalization. MATERIALS AND METHODS: We conducted a retrospective, monocentric study on a series of consecutive patients treated with mechanical thrombectomy. For each procedure, we extracted each attempt that used direct aspiration and rated the attempt as successful or unsuccessful. We also measured the occluded artery diameter and calculated the ratio between the occluded artery and the aspiration catheter diameters. We tested the association between the diameter ratio and the recanalization status. We also performed inter-rater agreement for the arterial diameter measurement between three interventional neuroradiologists. RESULTS: We included 119 patients with 201 attempts of direct aspiration. A higher diameter ratio was associated with a higher recanalization rate. The analysis in terciles showed that the odds of success were 4.80 higher when the ratio was >0.71 vs <0.54 (p < 0.01). Inter-rater agreement showed near-perfect intraclass correlation with 0.93 (0.91-0.94) consistency and 0.92 (0.90-0.94) absolute agreement. CONCLUSIONS: We demonstrated an association between higher recanalization and a diameter of ratio >0.71 between the aspiration catheter and the occluded artery. These results could guide intraoperative decisions regarding the appropriate selection of aspiration catheters during mechanical thrombectomy increasing the rate of successful recanalisation. A larger study could provide additional data to further specify the optimal ratio.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Acidente Vascular Cerebral / AVC Isquêmico Limite: Humans Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Acidente Vascular Cerebral / AVC Isquêmico Limite: Humans Idioma: En Ano de publicação: 2024 Tipo de documento: Article