Efficacy of combined use of a stent retriever and aspiration catheter in mechanical thrombectomy for acute ischemic stroke

Tomohiro Okuda, Koichi Arimura, Ryu Matsuo, So Tokunaga, Kenta Hara, Shinya Yamaguchi, Hidenori Yoshida, Ryota Kurogi, Katsuharu Kameda, Osamu Ito, Tomoyuki Tsumoto, Koji Iihara, Taichiro Mizokami, Takeshi Uwatoko, ataru nishimura, Katsuma Iwaki, Masahiro Mizoguchi

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)

Abstract

Background The efficacy of combined stent retriever (SR) and aspiration catheter (AC; combined technique: CBT) use for acute ischemic stroke (AIS) is unclear. We investigated the safety and efficacy of single-unit CBT (SCBT)—retrieving the thrombus as a single unit with SR and AC into the guide catheter—compared with single use of either SR or contact aspiration (CA). Methods We analysed 763 consecutive patients who underwent mechanical thrombectomy for AIS between January 2013 and January 2020, at six comprehensive stroke centers. Patients were divided into SCBT and single device (SR/CA) groups. The successful recanalization with first pass (SRFP) and other procedural outcomes were compared between groups. Results Overall, 240 SCBT and 301 SR/CA (SR 128, CA 173) patients were analyzed. SRFP (modified Thrombolysis In Cerebral Infarction (mTICI) ≥2c, 43.3% vs 27.9%, p<0.001; mTICI 3, 35.8% vs 25.5%, p=0.009) and final mTICI ≥2b recanalization (89.1% vs 82.0%, p=0.020) rates were significantly higher, puncture-to-reperfusion time was shorter (median (IQR) 43 (31.5–69) vs 55 (38–82.2) min, p<0.001), and the number of passes were fewer (mean±SD 1.72±0.92 vs 1.99±1.01, p<0.001) in the SCBT group. Procedural complications were similar between the groups. In subgroup analysis, SCBT was more effective in women, cardioembolic stroke patients, and internal carotid artery and M2 occlusions. Conclusions SCBT increases the SRFP rate and shortens the puncture-to-reperfusion time without increasing procedural complications.

Original languageEnglish
Pages (from-to)892-897
Number of pages6
JournalJournal of neurointerventional surgery
Volume14
Issue number9
DOIs
Publication statusPublished - Sept 2022

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

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