Universität zu Köln

Kabbasch, Christoph, Mpotsaris, Anastasios ORCID: 0000-0002-1275-8164, Chang, De-Hua, Hiss, Sonja, Dorn, Franziska ORCID: 0000-0001-9093-8307, Behme, Daniel, Onur, Oezguer and Liebig, Thomas ORCID: 0000-0001-5640-7780 (2016). Mechanical thrombectomy with the Trevo ProVue device in ischemic stroke patients: does improved visibility translate into a clinical benefit? J. NeuroInterventional Surg., 8 (8). S. 778 - 784. LONDON: BMJ PUBLISHING GROUP. ISSN 1759-8486

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Abstract

Purpose To investigate the efficacy and safety of the Trevo ProVue (TPV) stent retriever in stroke patients with large artery occlusions, with particular attention to the full structural radiopacity of the TPV. Materials and methods Case files and images of TPV treatments were reviewed for clinical and technical outcome data, including revascularization rates, device and procedure related complications, and outcome at discharge and after 90days. Results 76 patients were treated with TPV. Mean National Institutes of Health Stroke Scale (NIHSS) score was 18 and 68% had additional intravenous thrombolysis. 63 occlusions were in the anterior circulation: 44 M1 (58%), 8 M2 (11%), 8 internal carotid artery-terminus (11%), 2 internal carotid artery- left (3%), 1 A2 (1%), and 13 vertebrobasilar (17%). 58 of 76 (76%) were solely treated with TPV; the remainder were treated with additional stent retrievers. Mean number of passes in TPV only cases was 2.2 (SD 1.2). In rescue cases, 3.2 (SD 2.2) passes were attempted with the TPV followed by 2.6 rescue device passes (SD 2). TPV related adverse events occurred in 4/76 cases (5%) and procedural events in 6/76 cases (8%). Mean procedural duration was 64min (SD 42). Thrombolysis in Cerebral Infarction (TICI) 2b/3 recanalization was achieved in 69/76 patients (91%), including 50% TICI 3. Of 56 survivors (74%), 37 (49%) showed a favorable outcome at 90days (Solitaire With the Intention for Thrombectomy trial criteria), statistically associated with age, baseline NIHSS, onset to revascularization time, and TICI 2b-3 reperfusion. TPV radiopacity allowed for visual feedback, changing the methodology of stent retriever use in 44/76 cases (58%). Conclusions Neurothrombectomy with TPV is feasible, effective, and safe. The recanalization rate compares favorably with reported data in the literature. Improved structural radiopacity may facilitate neurothrombectomy or influence the course of action during retrieval.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kabbasch, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Mpotsaris, Anastasios UNSPECIFIED orcid.org/0000-0002-1275-8164 UNSPECIFIED Chang, De-Hua UNSPECIFIED UNSPECIFIED UNSPECIFIED Hiss, Sonja UNSPECIFIED UNSPECIFIED UNSPECIFIED Dorn, Franziska UNSPECIFIED orcid.org/0000-0001-9093-8307 UNSPECIFIED Behme, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Onur, Oezguer UNSPECIFIED UNSPECIFIED UNSPECIFIED Liebig, Thomas UNSPECIFIED orcid.org/0000-0001-5640-7780 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-267750
DOI:	10.1136/neurintsurg-2015-011861
Journal or Publication Title:	J. NeuroInterventional Surg.
Volume:	8
Number:	8
Page Range:	S. 778 - 784
Date:	2016
Publisher:	BMJ PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	1759-8486
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INTRACEREBRAL ARTERY OCCLUSIONS; FLOW RESTORATION DEVICE; SOLITAIRE STENT; ENDOVASCULAR TREATMENT; ANTERIOR CIRCULATION; RANDOMIZED-TRIAL; MERCI RETRIEVER; SINGLE-CENTER; IN-VITRO; RECANALIZATION Multiple languages Neuroimaging; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/26775