P73 Quantification of distal emboli due to contrast injections. (29th August 2022)

• Record Type: Journal Article
• Authors: Tiberi, R; Li, J; Tomasello, A; Ribo, M
• Is Part Of: Journal of neurointerventional surgery. Volume 14(2022)Supplement 2
• Page Start: A37
• Page End: A37
• Publication Date: 2022-08-29
• Subjects: Nervous system -- Surgery -- Periodicals; Cerebrovascular disease -- Surgery -- Periodicals; 617.48
• DOI: 10.1136/neurintsurg-2022-ESMINT.93
• Languages: English
• ISSNs: 1759-8478

Abstract

Abstract : Introduction: During the mechanical thrombectomy (MT), contrast injections through the deployed stentriever (SR) are commonly performed to visualize arterial segments beyond the occlusion. Aim of study: To study the potential generation of distal emboli due to these contrast injections. Methods: Fragment-prone clot analogs (Length=7.74±1.92 mm, Diameter=3 mm) were used to embolize M1-MCA in a 3D-printed neurovascular model. After SR deployment (Solitaire 4x20mm), 6 mL contrast injections through a distal access catheter (React 0.071'') were performed and generated clot fragments were collected in an output filter before retrieving the SR. Collected thromboemboli were analyzed (size and number) with an image processing algorithm. Sixty-five experiments were performed to create a control group (n=13: SR deployment without contrast injection) and four experimental groups (n=13 each) combining injection location (Proximal: ICA vs. Distal: M1-MCA) and injection rate (fast: 3 ml/s vs. slow: 1 ml/s). Results: The distal/fast combination generated significantly larger particles (mean±SD=1.9±1.4 mm) than distal/slow (0.85±0.58 mm; p<0.01), proximal/fast (0.75±0.35 mm; p<0.01) or proximal/slow (0.92±0.46 mm; p<0.01). In the control group, the number (p<0.01) and size of emboli (0.38±0.47 mm; p<0.05) were significantly lower than in any other combination. Conclusions: Contrast injection through a deployed SR may induce distal embolization. Neurointerventionalists should carefully consider performing these injections and, if necessary, measures to minimize distal embolization should be adopted. References: Kurre, W., Vorlaender, K., Aguilar-Pérez, M., Schmid, E., Bäzner, H., & Henkes, H. Frequency and relevance of anterior cerebral artery embolism caused by mechanical thrombectomy of middle cerebral artery occlusion. American Journal of Neuroradiology 2013;34 (8), 1606–1611. Do you have any conflict of interest to declare? : No