Universität zu Köln

Le Blanc, Markus, Maus, Volker ORCID: 0000-0001-5097-2631, Kabbasch, Christoph, Dorn, Franziska ORCID: 0000-0001-9093-8307, Chang, De-Hua, Liebig, Thomas, Mpotsaris, Anastasios ORCID: 0000-0002-1275-8164 and Borggrefe, Jan ORCID: 0000-0003-2908-7560 (2019). Effects of Intermediate Catheter Evolution on Technical Outcome of Mechanical Thrombectomy-A Comparison of the Performance of Two Distal Access Catheters in Mechanical Thrombectomy of Acute Ischemic Stroke. World Neurosurg., 123. S. E433 - 7. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1878-8769

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Abstract

OBJECTIVE: Fast and secure access to intracranial vessel occlusion is essential for mechanical thrombectomy (MT) in the treatment of acute ischemic stroke. We compared 2 intermediate distal access catheters (DAC: Distal Access Catheter [C1] and SOFIA: Soft torquable catheter Optimized For Intracranial Access [C2]) for procedural speed and safety of MTas well as clinical outcome at discharge and after 90 days. METHODS: This is a retrospective study of all 398 consecutive patients receiving MT with C1 or C2 for the treatment of acute ischemic stroke between September 2010 and June 2016, using a propensity score matched cohort. Baseline characteristics, clinical outcome, and procedural factors such as the number of retrieval attempts or duration of procedure were analyzed. RESULTS: A total of 282 patients (70.9%) underwent MT with C1 and 116 patients (29.1%) with C2. MT with C2 was faster with an average duration of 69.8 +/- 51 minutes (mean +/- standard deviation) compared with 80.6 +/- 54 minutes with C1 (P < 0.05). The average number of necessary stent-retriever maneuvers was significantly lower with C2 (1.8 +/- 1.7 vs. 3.2 +/- 2.5, P < 0.0001). Successful MT with aspiration only yielded higher modified Thrombolysis in Cerebral Infarction rates (mTIC 2b/3 69.9% vs. 31.5%, P < 0.0001) with C2. Modified Rankin Scale at discharge was significantly lower with C2 (3.5 +/- 1.9) versus C1 (3.9 +/- 1.7, P < 0.05). No significant differences of modified Rankin Scale 90 were observed. CONCLUSIONS: The use of C2 resulted in reduced procedural times with less stent-retriever maneuvers. Clinical outcome at discharge was better for C2 catheters, whereas no significant difference of outcome was apparent after 90 days.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Le Blanc, Markus UNSPECIFIED UNSPECIFIED UNSPECIFIED Maus, Volker UNSPECIFIED orcid.org/0000-0001-5097-2631 UNSPECIFIED Kabbasch, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Dorn, Franziska UNSPECIFIED orcid.org/0000-0001-9093-8307 UNSPECIFIED Chang, De-Hua UNSPECIFIED UNSPECIFIED UNSPECIFIED Liebig, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Mpotsaris, Anastasios UNSPECIFIED orcid.org/0000-0002-1275-8164 UNSPECIFIED Borggrefe, Jan UNSPECIFIED orcid.org/0000-0003-2908-7560 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-154901
DOI:	10.1016/j.wneu.2018.11.185
Journal or Publication Title:	World Neurosurg.
Volume:	123
Page Range:	S. E433 - 7
Date:	2019
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1878-8769
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TISSUE-PLASMINOGEN ACTIVATOR; 1ST PASS TECHNIQUE; ENDOVASCULAR TREATMENT; EMBOLUS REMOVAL; STENT-RETRIEVER; ADAPT TECHNIQUE; ASPIRATION; REVASCULARIZATION; EXPERIENCE; SAFETY Multiple languages Clinical Neurology; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/15490