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Clinical Neuroradiology
Published in: Clinical Neuroradiology 4/2019

01-12-2019 | Original Article

The SAVE Technique

Large-Scale Experience for Treatment of Intracranial Large Vessel Occlusions

Authors: Volker Maus, Silja Henkel, Alexander Riabikin, Christian Riedel, Daniel Behme, Ioannis Tsogkas, Amelie Carolina Hesse, Nuran Abdullayev, Olav Jansen, Martin Wiesmann, Anastasios Mpotsaris, Marios-Nikos Psychogios

Published in: Clinical Neuroradiology | Issue 4/2019

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Abstract

Background

The stent retriever assisted vacuum-locked extraction (SAVE) technique was introduced as an effective thrombectomy method in stroke patients suffering from intracranial large vessel occlusion (LVO). This article presents our multicenter, large-scale experience with SAVE.

Methods

The study involved a retrospective core team analysis of 200 patients undergoing mechanical thrombectomy using the SAVE technique due to intracranial LVO at 4 German centers. Primary endpoints were first-pass and overall complete/near complete reperfusion, defined as a modified thrombolysis in cerebral infarction (mTICI) score of 2c and 3. Secondary endpoints were the number of passes, time from groin puncture to reperfusion, embolization to new territories (ENT), postinterventional symptomatic intracranial hemorrhage (sICH), and favorable outcome at discharge, defined as a modified Rankin Scale (mRS) score ≤ 2.

Results

The median age was 78 years (interquartile range IQR 68–85). Median National Institutes of Health stroke scale (NIHSS) at admission was 16 (IQR 12–20). Occlusions sites were: internal carotid artery (ICA-T) in 39/200 (19.5%), M1 in 126/200 (63%), M2 in 30/200 (15%), and others in 5/200 (2.5%) cases. The primary endpoints were documented in 114/200 (57% first pass mTICI 2c or 3) and 154/200 (77% overall mTICI 2c or 3) patients, respectively. The overall median time from groin puncture to reperfusion was 34 min (IQR 25–52) with a median of 1 (IQR 1–2) attempts. An ENT was observed in 3 patients (1.5%) and the rate of sICH was 2.6%. The rate of successful reperfusion (mTICI ≥ 2b) on final angiograms was 95%. At discharge, 73/200 (36.5%) patients revealed a favorable outcome.

Conclusion

Mechanical thrombectomy using the SAVE technique seems to be effective, fast and safe. First-line use of SAVE leads to high rates of complete and near complete reperfusion.
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Metadata
Title
The SAVE Technique
Large-Scale Experience for Treatment of Intracranial Large Vessel Occlusions
Authors
Volker Maus
Silja Henkel
Alexander Riabikin
Christian Riedel
Daniel Behme
Ioannis Tsogkas
Amelie Carolina Hesse
Nuran Abdullayev
Olav Jansen
Martin Wiesmann
Anastasios Mpotsaris
Marios-Nikos Psychogios
Publication date
01-12-2019
Publisher
Springer Berlin Heidelberg
Published in
Clinical Neuroradiology / Issue 4/2019
Print ISSN: 1869-1439
Electronic ISSN: 1869-1447
DOI
https://doi.org/10.1007/s00062-018-0702-4

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