Hybrid mechanical thrombectomy for acute ischemic stroke using an intermediate aspiration catheter and Trevo stent simultaneously. (June 2020)

• Record Type: Journal Article
• Authors: Kim, Seung Hwan; Lee, Hyungon; Kim, Su Bin; Kim, Sung Tae; Baek, Jin Wook; Heo, Young Jin; Jeong, Hae Woong; Kim, Hye Jin; Park, Jung Hyun; Kim, Jung-Soo; Jin, Sung-Chul
• Is Part Of: Journal of clinical neuroscience. Volume 76(2020)
• Page Start: 9
• Page End: 14
• Publication Date: 2020-06
• Subjects: Mechanical thrombectomy -- Stent retriever -- Catheter aspiration -- Intermediate aspiration catheter; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2020.04.079
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Catheter aspiration and stent retrievers have limitations (thrombus migration). We designed hybrid MT using an intermediate aspiration catheter and a Trevo stent. Hybrid MT had a shorter procedure time and fewer attempts. Hybrid MT showed a higher first pass successful recanalization rate. Abstract: Purpose: To overcome the limitations of traditional mechanical thrombectomy (MT), including catheter aspiration and stent retrievers, such as thrombus fragmentation or migration, we designed hybrid MT using an intermediate aspiration catheter and a Trevo stent simultaneously. We retrospectively compared hybrid MT with the traditional MT. Methods: From January 2017 to January 2019, we performed MT on 91 occlusions, including internal carotid artery bifurcation (n = 17), M1 segment (n = 53) and M2 segment (n = 21), using hybrid MT (n = 42) and traditional MT (n = 49). Results: Hybrid MT had a shorter procedure time (52.4 ± 22.0 vs. 73.0 ± 36.2 min, p = 0.002) and fewer attempts (1.50 ± 0.86 vs. 1.92 ± 1.10 times, p = 0.049) than traditional MT did. Hybrid MT achieved more good clinical outcome (3-month modified Rankin Scale score, 2 or less) and better successful recanalization (Thrombolysis In Cerebral Infarction grade, 2b or 3) than traditional MT did, but the difference was not significant (61.9% vs. 55.1%, p = 0.531, 92.9% vs. 87.8%, p = 0.498). Hybrid MT showed a higher first pass successful recanalization rate than traditional MT did (69.0% vs. 40.8%, p = 0.011). Multivariable logistic regression analysis demonstrated that first pass successful recanalization is related to the M1 segment rather than other segments (adjusted odds ratio (OR); 3.277, confidence interval (CI); 1.227–8.749, p = 0.018) and hybrid MT rather than traditional MT (adjusted OR; 4.995, CI; 1.725–14.460, p = 0.003). Conclusions: Hybrid MT can be used as a first-line MT modality, particularly in M1 occlusion, based on our high first pass successful recanalization results.