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01-12-2020 | Stroke | Research article

Immediate effects of first-line thrombectomy devices for intracranial atherosclerosis-related occlusion: stent retriever versus contact aspiration

Authors: Joonsang Yoo, Seong-Joon Lee, Jeong-Ho Hong, Yong-Won Kim, Ji Man Hong, Chang-Hyun Kim, Dong-Hun Kang, Jin Wook Choi, Yong-Sun Kim, Sung-Il Sohn, Yang-Ha Hwang, Jin Soo Lee

Published in: BMC Neurology | Issue 1/2020

Abstract

Background

Although stent retriever (SR) is recommended as a frontline device of endovascular treatment (EVT) for embolic large artery occlusion causing acute ischemic stroke, contact aspiration (CA) device showed similar efficacy in the recent trials. However, the efficacy of the both devices as first-line therapy for intracranial atherosclerotic stenosis (ICAS)-related large vessel occlusion has not yet been established. Therefore, we compared the immediate effects and final outcomes of SR and CA as first-line devices for treating ICAS-related occlusions.

Methods

We retrospectively analyzed the data of patients who underwent EVT for acute ischemic stroke from the registry of three Korean hospitals. Patients with ICAS-related occlusion who were treated within 24 h of onset of the symptoms were included. We investigated immediate reperfusion performance, immediate safety outcomes, and 3-month clinical outcomes for the two first-line devices.

Results

Of the 720 registered patients, 111 were eligible for this study. Forty-nine patients (44.1%) used SR and 62 (55.9%) used CA as the first-line device. Achieving successful reperfusion immediately after first-line thrombectomy was more frequent in the SR group than that in the CA group (77.6% vs. 43.5%, p = 0.001), with fewer additional rescue treatments (12.2% vs. 59.7%, p < 0.001). The incidence of iatrogenic dissection or rupture was lower in the SR group than that in the CA group (8.2% vs. 29.0%, p = 0.012). After additional rescue treatments, however, the final successful reperfusion rate did not differ between the two groups (SR 87.8% vs. CA 77.4%, p = 0.247), and there was no significant difference in the 3-month good outcomes (modified Rankin Scale, p = 0.524).

Conclusions

First-line SR thrombectomy showed higher immediate reperfusion and less vessel injury for ICAS-related occlusions than CA. However, there was no significant difference in the final reperfusion status or 3-month outcomes from additional rescue treatments.

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Title: Immediate effects of first-line thrombectomy devices for intracranial atherosclerosis-related occlusion: stent retriever versus contact aspiration
Authors: Joonsang Yoo
Seong-Joon Lee
Jeong-Ho Hong
Yong-Won Kim
Ji Man Hong
Chang-Hyun Kim
Dong-Hun Kang
Jin Wook Choi
Yong-Sun Kim
Sung-Il Sohn
Yang-Ha Hwang
Jin Soo Lee
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Stroke
Foreign Body Aspiration
Vessel Injury
Foreign Body Aspiration
Aspiration
Arterial Occlusive Disease
Thrombectomy
Published in: BMC Neurology / Issue 1/2020
Electronic ISSN: 1471-2377
DOI: https://doi.org/10.1186/s12883-020-01862-6

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Springer Medicine

Immediate effects of first-line thrombectomy devices for intracranial atherosclerosis-related occlusion: stent retriever versus contact aspiration

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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