Universität zu Köln

Maus, Volker, Henkel, Silja, Riabikin, Alexander, Riedel, Christian, Behme, Daniel, Tsogkas, Ioannis, Hesse, Amelie Carolina, Abdullayev, Nuran ORCID: 0000-0003-4522-537X, Jansen, Olav, Wiesmann, Martin, Mpotsaris, Anastasios ORCID: 0000-0002-1275-8164 and Psychogios, Marios-Nikos (2019). The SAVE Technique: Large-Scale Experience for Treatment of Intracranial Large Vessel Occlusions. Clin. Neuroradiol., 29 (4). S. 669 - 677. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1869-1447

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Abstract

BackgroundThe 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.MethodsThe 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.ResultsThe 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 34min (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.ConclusionMechanical 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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Maus, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED Henkel, Silja UNSPECIFIED UNSPECIFIED UNSPECIFIED Riabikin, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Riedel, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Behme, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Tsogkas, Ioannis UNSPECIFIED UNSPECIFIED UNSPECIFIED Hesse, Amelie Carolina UNSPECIFIED UNSPECIFIED UNSPECIFIED Abdullayev, Nuran UNSPECIFIED orcid.org/0000-0003-4522-537X UNSPECIFIED Jansen, Olav UNSPECIFIED UNSPECIFIED UNSPECIFIED Wiesmann, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Mpotsaris, Anastasios UNSPECIFIED orcid.org/0000-0002-1275-8164 UNSPECIFIED Psychogios, Marios-Nikos UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-125586
DOI:	10.1007/s00062-018-0702-4
Journal or Publication Title:	Clin. Neuroradiol.
Volume:	29
Number:	4
Page Range:	S. 669 - 677
Date:	2019
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1869-1447
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ACUTE ISCHEMIC-STROKE; STENT-RETRIEVER THROMBECTOMY; BALLOON GUIDE CATHETER; MECHANICAL THROMBECTOMY; ENDOVASCULAR TREATMENT; ASPIRATION CATHETER; REVASCULARIZATION; STANDARDS; DEVICE; TRIAL Multiple languages Clinical Neurology; Radiology, Nuclear Medicine & Medical Imaging Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/12558