Protected stent retriever thrombectomy prevents iatrogenic emboli in new vascular territories

Neuroradiology
Pascal P Klinger-GratzM El-Koussy

Abstract

Diagnostic tools to show emboli reliably and protection techniques against embolization when employing stent retrievers are necessary to improve endovascular stroke therapy. The aim of the present study was to investigate iatrogenic emboli using susceptibility-weighted imaging (SWI) in an open series of patients who had been treated with stent retriever thrombectomy using emboli protection techniques. Patients with anterior circulation stroke examined with MRI before and after stent retriever thrombectomy were assessed for iatrogenic embolic events. Thrombectomy was performed in flow arrest and under aspiration using a balloon-mounted guiding catheter, a distal access catheter, or both. In 13 of 57 patients (22.8%) post-interventional SWI sequences detected 16 microemboli. Three of them were associated with small ischemic lesions on diffusion-weighted imaging (DWI). None of the microemboli were located in a new vascular territory, none showed clinical signs, and all 13 patients have been rated as Thrombolysis in Cerebral Infarction (TICI) 2b (n = 3) or 3 (n = 10). Retrospective reevaluation of the digital subtraction angiography (DSA) detected discrete flow stagnation nearby the iatrogenic microemboli in four patients with a po...Continue Reading

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Citations

Feb 19, 2016·Journal of Neurointerventional Surgery·Justus F KleineJohannes Kaesmacher
Mar 9, 2017·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Ming WeiHong Li
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Mar 8, 2017·Journal of Korean Neurosurgical Society·Jae-Sang OhKyeong-Seok Lee
May 16, 2020·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·D VoldersA Weill
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Apr 2, 2020·Interventional Neurology·Asim RizviDavid F Kallmes

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Methods Mentioned

BETA
sedation

Software Mentioned

MELT
MR CLEAN
SPSS
REVASCAT
TREVO
Prime
PROACT
SWIFT

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