22 December 2018 : Clinical Research
Comparison of Mechanical Thrombectomy with Contact Aspiration, Stent Retriever, and Combined Procedures in Patients with Large-Vessel Occlusion in Acute Ischemic Stroke
Václav Procházka1ABCDEFG*, Tomas Jonszta1ADEF, Daniel Czerny1ABDEF, Jan Krajca1DE, Martin Roubec2ABCDF, Eva Hurtikova2BD, Rene Urbanec3BF, Dana Streitová34BE, Lubomir Pavliska5BCD, Adela Vrtkova67BCDEFDOI: 10.12659/MSM.913458
Med Sci Monit 2018; 24: CLR9342-9353
Abstract
BACKGROUND: We investigated the properties and effects of 5 mechanical thrombectomy procedures in patients with acute ischemic stroke. The relationships between the type of procedure, the time required, the success of recanalization, and the clinical outcome were analyzed.
MATERIAL AND METHODS: This prospective comparative analysis included 500 patients with acute ischemic stroke and large-vessel occlusion. We compared contact aspiration thrombectomy (ADAPT, n=100), stent retriever first line (SRFL, n=196), the Solumbra technique (n=64), mechanical thrombectomy plus stent implantation (n=81), and a combined procedure (n=59).
RESULTS: ADAPT provided shorter procedure (P<0.001) and recanalization times (P<0.001) than the other techniques. Better clinical outcome was achieved for ischemia in the anterior circulation than ischemia in the posterior fossa (P<0.001). Compared to the other techniques, patients treated with ADAPT procedure had increased odds of achieving better mTICI scores (P=0.002) and clinical outcome (NIHSS) after 7 days (P=0.003); patients treated with SRFL had increased odds of achieving better long-term clinical status (3M-mRS=0–2; P=0.040). Patients with SRFL and intravenous thrombolysis (IVT) had increased odds of better clinical status (3M-mRS=0–2; P=0.031) and decreased odds of death (P=0.005) compared to patients with SRFL without IVT. The other treatment approaches had no additional effect of IVT. Patients with SRFL with a mothership transfer had increased odds of achieving favorable clinical outcome (3M-mRS) compared to SRFL with the drip-and-ship transfer paradigm (P=0.015).
CONCLUSIONS: Our results showed that ADAPT and SRFL provided significantly better outcomes compared to the other examined techniques. A mothership transfer and IVT administration contributed to the success of the SRFL approach.
Keywords: Stroke, Thrombectomy, Thrombolytic Therapy
Editorial
01 May 2022 : Editorial
Editorial: Cardiovascular Complications at One Year After SARS-CoV-2 Infection are Independent of Underlying Cardiovascular Risk Factors or Severity of COVID-19DOI: 10.12659/MSM.937048
Med Sci Monit 2022; 28:e937048
SARS-CoV-2/COVID-19
04 May 2022 : Clinical Research
Effects of Wearing Face Masks on Exercise Capacity and Ventilatory Anaerobic Threshold in Healthy Subjects ...Med Sci Monit In Press; DOI: 10.12659/MSM.936069
22 April 2022 : Clinical Research
Factors Associated with Falls During Hospitalization for Coronavirus Disease 2019 (COVID-19)Med Sci Monit In Press; DOI: 10.12659/MSM.936547
27 April 2022 : Meta-Analysis
Effect of the COVID-19 Pandemic on Serum Vitamin D Levels in People Under Age 18 Years: A Systematic Review...Med Sci Monit In Press; DOI: 10.12659/MSM.935823
06 May 2022 : Clinical Research
COVID-19: Another Cause of Dental Anxiety?Med Sci Monit 2022; 28:e936535
In Press
19 May 2022 : Clinical Research
Association Between Serum Homocysteine Levels and Severity of Diabetic Kidney Disease in 489 Patients with ...Med Sci Monit In Press; DOI: 10.12659/MSM.936323
18 May 2022 : Clinical Research
Physical and Psychosocial Concept Domains Related to Health-Related Quality of Life (HRQL) in 50 Girls and ...Med Sci Monit In Press; DOI: 10.12659/MSM.936801
18 May 2022 : Clinical Research
Association Between Variants of the Mannose-Binding Lectin 2 Gene and Susceptibility to Sepsis in the Haina...Med Sci Monit In Press; DOI: 10.12659/MSM.936134
17 May 2022 : Clinical Research
Clinical Application of C-TIRADS Category and Contrast-Enhanced Ultrasound in Differential Diagnosis of Sol...Med Sci Monit In Press; DOI: 10.12659/MSM.936368
Most Viewed Current Articles
30 Dec 2021 : Clinical Research
Retrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis o...DOI :10.12659/MSM.935379
Med Sci Monit 2021; 27:e935379
08 Mar 2022 : Review article
A Review of the Potential Roles of Antioxidant and Anti-Inflammatory Pharmacological Approaches for the Man...DOI :10.12659/MSM.936292
Med Sci Monit 2022; 28:e936292
01 Nov 2020 : Review article
Long-Term Respiratory and Neurological Sequelae of COVID-19DOI :10.12659/MSM.928996
Med Sci Monit 2020; 26:e928996
01 Jan 2022 : Editorial
Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...DOI :10.12659/MSM.935952
Med Sci Monit 2022; 28:e935952