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
Vladimir KalousekVallabh Janardhan

Abstract

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. In a prospective observational cohort study, 40 consecutive patients underwent cyclical aspiration thrombectomy using CLEARTM Aspiration System (Insera Therapeutics Inc., Dallas, TX). Primary outcome included FPE with complete/near-complete reperfusion (TICI 2c/3 FPE). Secondary outcomes included early neurological improvement measured by the National Institute of Health Stroke Scale (NIHSS), safety outcomes, and functional outcomes using modified Rankin Scale (mRS). Outcomes were compared against published historical controls. 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...Continue Reading

References

Mar 16, 2013·Stroke; a Journal of Cerebral Circulation·Ju-Yu ChuehMatthew J Gounis
Aug 8, 2013·Stroke; a Journal of Cerebral Circulation·Osama O ZaidatUNKNOWN STIR Thrombolysis in Cerebral Infarction (TICI) Task Force
Feb 12, 2015·The New England Journal of Medicine·Bruce C V CampbellUNKNOWN EXTEND-IA Investigators
Apr 18, 2015·The New England Journal of Medicine·Jeffrey L SaverUNKNOWN SWIFT PRIME Investigators
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Feb 7, 2017·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Daniel BehmeMarios-Nikos Psychogios
Oct 1, 2017·Journal of Neurointerventional Surgery·Osama O ZaidatThanh N Nguyen
Nov 14, 2017·The New England Journal of Medicine·Raul G NogueiraUNKNOWN DAWN Trial Investigators
Feb 21, 2018·Stroke; a Journal of Cerebral Circulation·Osama O ZaidatRaul G Nogueira
Apr 13, 2018·Stroke; a Journal of Cerebral Circulation·Osama O ZaidatTommy Andersson
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Sep 9, 2018·Journal of Neurointerventional Surgery·David S LiebeskindUNKNOWN HERMES Collaborators
Feb 6, 2019·Journal of Neurointerventional Surgery·Rose A ArslanianJu-Yu Chueh
Sep 1, 2019·Journal of Neurointerventional Surgery·Célina DucrouxUNKNOWN ASTER Trial investigators
May 7, 2020·The New England Journal of Medicine·Pengfei YangUNKNOWN DIRECT-MT Investigators
Jun 14, 2020·Journal of Neurointerventional Surgery·William BoisseauRaphaël Blanc
Aug 11, 2020·Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging·Vallabh JanardhanVladimir Kalousek
Feb 18, 2021·Journal of Neurointerventional Surgery·Ching-Jen ChenUNKNOWN STAR collaborators

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