Clot reduction prior to embolectomy: mSAVE as a first-line technique for large clots
2019 | journal article. A publication with affiliation to the University of Göttingen.
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Clot reduction prior to embolectomy: mSAVE as a first-line technique for large clots
Psychogios, M.-N.; Tsogkas, I.; Brehm, A.; Hesse, A.; McTaggart, R.; Goyal, M. & Maier, I. et al. (2019)
PLOS ONE, 14(5) art. e0216258. DOI: https://doi.org/10.1371/journal.pone.0216258
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- Authors
- Psychogios, Marios-Nikos; Tsogkas, Ioannis; Brehm, Alex; Hesse, Amelie; McTaggart, Ryan; Goyal, Mayank; Maier, Ilko; Schnieder, Marlena; Behme, Daniel; Maus, Volker
- Abstract
- INTRODUCTION: The "Stent retriever Assisted Vacuum-locked Extraction" (SAVE) technique is a promising embolectomy method for intracranial large vessel occlusion (LVO). We report our experience using a modified SAVE (mSAVE) approach for clot reduction prior to embolectomy in acute ischemic stroke patients with large clots. MATERIALS AND METHODS: We retrospectively analyzed 20 consecutive patients undergoing mSAVE in our center due to intracranial LVO. Angiographic data (including first-pass and overall complete reperfusion, defined as an expanded Thrombolysis in Cerebral Infarction (eTICI) score of 3, rate of successful reperfusion (eTICI ≥2c), number of passes, time from groin puncture to reperfusion) and clinical data (favorable outcome at 90 days, defined as modified Rankin Scale (mRS) ≤2) were assessed. RESULTS: First-pass and overall eTICI 3 reperfusion was reached in 13/20 (65%) and 14/20 (70%), respectively. The rate of successful reperfusion (eTICI ≥2c) after one pass was 85% and on final angiogram 90% with an average number of 1.1 ± 0.3 attempts. Eight out of 11 (73%) ICA occlusions were reperfused successfully and 5 (46%) completely after a single pass. Median groin to reperfusion time was 33 minutes (IQR 25-46). A favorable clinical outcome was achieved in 9/20 (45%) patients at discharge and after 90 days, respectively. CONCLUSION: Clot reduction followed by embolectomy (mSAVE) is feasible and may be an important tool in the treatment of large clots.
- Issue Date
- 2019
- Journal
- PLOS ONE
- Language
- English