Article ; Online: Cyclical aspiration using a novel mechanical thrombectomy device is associated with a high TICI 3 first pass effect in large-vessel strokes.
Journal of neuroimaging : official journal of the American Society of Neuroimaging
2021 Volume 31, Issue 5, Page(s) 912–924
Abstract: Background and purpose: Complete reperfusion (TICI 3) after the first thrombectomy attempt or first pass effect (FPE) is associated with best clinical outcomes in large-vessel occlusion (LVO) acute ischemic stroke. While endovascular therapy techniques ... ...
| Abstract | Background and purpose: Complete reperfusion (TICI 3) after the first thrombectomy attempt or first pass effect (FPE) is associated with best clinical outcomes in large-vessel occlusion (LVO) acute ischemic stroke. While endovascular therapy techniques have improved substantially, FPE remains low (24-30%), and new methods to improve reperfusion efficiency are needed. Methods: In a prospective observational cohort study, 40 consecutive patients underwent cyclical aspiration thrombectomy using CLEAR Results: Among 38 patients who met criteria for LVO, median age was 75 (range 31-96). FPE was high (TICI 3: 26/38 [68%], TICI 2c/3: 29/38 [76%]). Among anterior circulation strokes, core lab-adjudicated FPE remained high (TICI 3: 17/29 [59%], TICI 2c/3: 20/29 [69%]), with excellent final successful revascularization results (Final TICI 3: 24/29 [83%], Final TICI 2c/3: 27/29 [93%]). FPE in the CLEAR-1 cohort was significantly higher compared to FPE using existing devices (meta-analysis) from historical controls (TICI 2c/3: 76% vs. 28%, p = 0.0001). High rates of early neurological improvement were observed (delta NIHSS≥4: 35/38 [92.1%]; delta NIHSS≥10: 27/38 [71%]). Similarly, high rates of good functional outcomes (mRS 0-2: 32/38 [84%]) and low mortality (2/38 [5%]) were observed. Conclusion: Cyclical aspiration using the CLEAR |
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| MeSH term(s) | Adult ; Aged ; Aged, 80 and over ; Brain Ischemia/diagnostic imaging ; Brain Ischemia/surgery ; Humans ; Middle Aged ; Prospective Studies ; Retrospective Studies ; Stroke/diagnostic imaging ; Stroke/surgery ; Thrombectomy ; Treatment Outcome | |||||
| Language | English | |||||
| Publishing date | 2021-06-08 | |||||
| Publishing country | United States | |||||
| Document type | Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S. | |||||
| ZDB-ID | 1071724-9 | |||||
| ISSN | 1552-6569 ; 1051-2284 | |||||
| ISSN (online) | 1552-6569 | |||||
| ISSN | 1051-2284 | |||||
| DOI | 10.1111/jon.12889 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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