Skip to main content
Erschienen in: Clinical Neuroradiology 4/2019

06.09.2018 | Original Article

Delivery Assist Catheters

A new Device Class and Initial Experience in Mechanical Thrombectomy in Acute Ischemic Stroke Patients

verfasst von: Johannes A. R. Pfaff, Ralf Siekmann, Yogesh P. Shah, Peter A. Ringleb, Christian Ulfert, Kai Koller, Martin Bendszus, Markus A. Möhlenbruch

Erschienen in: Clinical Neuroradiology | Ausgabe 4/2019

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To report in vivo experience of a delivery assist catheter as ascending aid for a large-bore catheter for intracranial thromboaspiration.

Methods

Retrospective data collection and analysis of stroke databases of two comprehensive stroke centers focusing on technical and angiographic parameters – primary endpoint defined as reaching the occlusion with a large-bore reperfusion catheter – from patients receiving endovascular stroke treatment using an AXS Offset™ delivery assist catheter (Stryker, Fremont, CA, USA) between May 2017 and November 2017.

Results

Using the delivery assist catheter, a 6F catheter could be advanced to an intracranial occlusion for direct thromboaspiration in 30 (88.2%) out of a total of 34 patients (male: n = 14 out of 34 [41.2%], age in years: mean [SD]: 75 [11], median baseline NIHSS [National Institutes of Health stroke scale]: 16 [interquartile range, IQR 12-21]). In 4 out of 34 (11.7%) cases the occlusion could not be reached with the aspiration catheter because of a preceding non-occlusive arteriosclerotic plaque (n = 1, 2.9%) or because of severe elongation and tortuosity of the arterial access route (n = 3, 8.8%). After thromboaspiration mTICI (modified thrombolysis in cerebral infarction) 2b‑3 was reached in 14 out of 30 (46.7%) patients. In 21 out of 34 (61.8%) patients stent-retriever-maneuvers (median: 1 [IQR: 0‑2]) were needed. In 28 out of 34 (82.3%) patients final mTICI 2b-3 could be achieved.

Conclusion

Delivery assist catheters can be used as ascending aid for large-bore catheters for thromboaspiration in acute ischemic stroke, in particular to overcome vessel tortuosity and anatomic obstacles.
Literatur
1.
Zurück zum Zitat Turk AS, Spiotta A, Frei D, Mocco J, Baxter B, Fiorella D, Siddiqui A, Mokin M, Dewan M, Woo H, Turner R, Hawk H, Miranpuri A, Chaudry I. Initial clinical experience with the ADAPT technique: a direct aspiration first pass technique for stroke thrombectomy. J Neurointerv Surg. 2014;6:231–7.CrossRefPubMed Turk AS, Spiotta A, Frei D, Mocco J, Baxter B, Fiorella D, Siddiqui A, Mokin M, Dewan M, Woo H, Turner R, Hawk H, Miranpuri A, Chaudry I. Initial clinical experience with the ADAPT technique: a direct aspiration first pass technique for stroke thrombectomy. J Neurointerv Surg. 2014;6:231–7.CrossRefPubMed
2.
Zurück zum Zitat Turk AS, Frei D, Fiorella D, Mocco J, Baxter B, Siddiqui A, Spiotta A, Mokin M, Dewan M, Quarfordt S, Battenhouse H, Turner R, Chaudry I. ADAPT FAST study: a direct aspiration first pass technique for acute stroke thrombectomy. J Neurointerv Surg. 2014;6:260–4.CrossRefPubMed Turk AS, Frei D, Fiorella D, Mocco J, Baxter B, Siddiqui A, Spiotta A, Mokin M, Dewan M, Quarfordt S, Battenhouse H, Turner R, Chaudry I. ADAPT FAST study: a direct aspiration first pass technique for acute stroke thrombectomy. J Neurointerv Surg. 2014;6:260–4.CrossRefPubMed
3.
Zurück zum Zitat Möhlenbruch MA, Kabbasch C, Kowoll A, Broussalis E, Sonnberger M, Müller M, Wiesmann M, Trenkler J, Killer-Oberpfalzer M, Weber W, Mpotsaris A, Bendszus M, Stampfl S. Multicenter experience with the new SOFIA Plus catheter as a primary local aspiration catheter for acute stroke thrombectomy. J Neurointerv Surg. 2017;9:1223–7.CrossRefPubMed Möhlenbruch MA, Kabbasch C, Kowoll A, Broussalis E, Sonnberger M, Müller M, Wiesmann M, Trenkler J, Killer-Oberpfalzer M, Weber W, Mpotsaris A, Bendszus M, Stampfl S. Multicenter experience with the new SOFIA Plus catheter as a primary local aspiration catheter for acute stroke thrombectomy. J Neurointerv Surg. 2017;9:1223–7.CrossRefPubMed
4.
Zurück zum Zitat Kabbasch C, Möhlenbruch M, Stampfl S, Mpotsaris A, Behme D, Liebig T. First-line lesional aspiration in acute stroke thrombectomy using a novel intermediate catheter: Initial experiences with the SOFIA. Interv Neuroradiol. 2016;22:333–9.CrossRefPubMedPubMedCentral Kabbasch C, Möhlenbruch M, Stampfl S, Mpotsaris A, Behme D, Liebig T. First-line lesional aspiration in acute stroke thrombectomy using a novel intermediate catheter: Initial experiences with the SOFIA. Interv Neuroradiol. 2016;22:333–9.CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Takahira K, Kataoka T, Ogino T, Endo H, Nakamura H. Efficacy of a coaxial system with a compliant balloon catheter for navigation of the Penumbra reperfusion catheter in tortuous arteries: technique and case experience. J Neurosurg. 2017;126:1334–8.CrossRefPubMed Takahira K, Kataoka T, Ogino T, Endo H, Nakamura H. Efficacy of a coaxial system with a compliant balloon catheter for navigation of the Penumbra reperfusion catheter in tortuous arteries: technique and case experience. J Neurosurg. 2017;126:1334–8.CrossRefPubMed
6.
Zurück zum Zitat Kowoll A, Moreno A, Weber J, Loehr C, Gal G, Körner H, Berlis A, Weber W, Lo T. O‑009 multicentre experience with aspiration only technique for acute stroke thrombectomy using ace64. J Neurointerv Surg. 2015;7(Suppl 1):A5–A6.CrossRef Kowoll A, Moreno A, Weber J, Loehr C, Gal G, Körner H, Berlis A, Weber W, Lo T. O‑009 multicentre experience with aspiration only technique for acute stroke thrombectomy using ace64. J Neurointerv Surg. 2015;7(Suppl 1):A5–A6.CrossRef
7.
Zurück zum Zitat Vargas J, Spiotta A, Fargen K, Turner R, Chaudry I, Turk A. Long term experience using the ADAPT technique for the treatment of acute ischemic stroke. J Neurointerv Surg. 2017;9:437–41.CrossRefPubMed Vargas J, Spiotta A, Fargen K, Turner R, Chaudry I, Turk A. Long term experience using the ADAPT technique for the treatment of acute ischemic stroke. J Neurointerv Surg. 2017;9:437–41.CrossRefPubMed
8.
Zurück zum Zitat Kowoll A, Weber A, Mpotsaris A, Behme D, Weber W. Direct aspiration first pass technique for the treatment of acute ischemic stroke: initial experience at a European stroke center. J Neurointerv Surg. 2016;8:230–4.CrossRefPubMed Kowoll A, Weber A, Mpotsaris A, Behme D, Weber W. Direct aspiration first pass technique for the treatment of acute ischemic stroke: initial experience at a European stroke center. J Neurointerv Surg. 2016;8:230–4.CrossRefPubMed
9.
Zurück zum Zitat Sallustio F, Pampana E, Davoli A, Merolla S, Koch G, Alemseged F, Panella M, D’Agostino VC, Mori F, Morosetti D, Konda D, Fabiano S, Diomedi M, Gandini R. Mechanical thrombectomy of acute ischemic stroke with a new intermediate aspiration catheter: preliminary results. J Neurointerv Surg. 2018 Feb 8. doi: 10.1136/neurintsurg-2017-013679. [Epub ahead of print]CrossRefPubMed Sallustio F, Pampana E, Davoli A, Merolla S, Koch G, Alemseged F, Panella M, D’Agostino VC, Mori F, Morosetti D, Konda D, Fabiano S, Diomedi M, Gandini R. Mechanical thrombectomy of acute ischemic stroke with a new intermediate aspiration catheter: preliminary results. J Neurointerv Surg. 2018 Feb 8. doi: 10.1136/neurintsurg-2017-013679. [Epub ahead of print]CrossRefPubMed
10.
Zurück zum Zitat Boeckh-Behrens T, Schubert M, Förschler A, Prothmann S, Kreiser K, Zimmer C, Riegger J, Bauer J, Neff F, Kehl V, Pelisek J, Schirmer L, Mehr M, Poppert H. The impact of histological clot composition in embolic stroke. Clin Neuroradiol. 2016;26:189–97.CrossRefPubMed Boeckh-Behrens T, Schubert M, Förschler A, Prothmann S, Kreiser K, Zimmer C, Riegger J, Bauer J, Neff F, Kehl V, Pelisek J, Schirmer L, Mehr M, Poppert H. The impact of histological clot composition in embolic stroke. Clin Neuroradiol. 2016;26:189–97.CrossRefPubMed
11.
Zurück zum Zitat Lapergue B, Blanc R, Gory B, Labreuche J, Duhamel A, Marnat G, Saleme S, Costalat V, Bracard S, Desal H, Mazighi M, Consoli A, Piotin M; ASTER Trial Investigators. Effect of endovascular contact aspiration vs stent retriever on revascularization in patients with acute ischemic stroke and large vessel occlusion: the aster randomized clinical trial. JAMA. 2017;318:443–52.CrossRefPubMedPubMedCentral Lapergue B, Blanc R, Gory B, Labreuche J, Duhamel A, Marnat G, Saleme S, Costalat V, Bracard S, Desal H, Mazighi M, Consoli A, Piotin M; ASTER Trial Investigators. Effect of endovascular contact aspiration vs stent retriever on revascularization in patients with acute ischemic stroke and large vessel occlusion: the aster randomized clinical trial. JAMA. 2017;318:443–52.CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Maus V, Behme D, Kabbasch C, Borggrefe J, Tsogkas I, Nikoubashman O, Wiesmann M, Knauth M, Mpotsaris A, Psychogios MN. Maximizing first-pass complete reperfusion with SAVE. Clin Neuroradiol. 2018;28:327-38.CrossRefPubMed Maus V, Behme D, Kabbasch C, Borggrefe J, Tsogkas I, Nikoubashman O, Wiesmann M, Knauth M, Mpotsaris A, Psychogios MN. Maximizing first-pass complete reperfusion with SAVE. Clin Neuroradiol. 2018;28:327-38.CrossRefPubMed
13.
Zurück zum Zitat Saver JL, Jahan R, Levy EI, Jovin TG, Baxter B, Nogueira R, Clark W, Budzik R, Zaidat OO; SWIFT Trialists. SOLITAIRE with the intention for thrombectomy (SWIFT) trial: design of a randomized, controlled, multicenter study comparing the SOLITAIRE Flow Restoration device and the MERCI Retriever in acute ischaemic stroke. Int J Stroke. 2014;9:658–68.CrossRefPubMed Saver JL, Jahan R, Levy EI, Jovin TG, Baxter B, Nogueira R, Clark W, Budzik R, Zaidat OO; SWIFT Trialists. SOLITAIRE with the intention for thrombectomy (SWIFT) trial: design of a randomized, controlled, multicenter study comparing the SOLITAIRE Flow Restoration device and the MERCI Retriever in acute ischaemic stroke. Int J Stroke. 2014;9:658–68.CrossRefPubMed
14.
Zurück zum Zitat Hacke W, Kaste M, Fieschi C, von Kummer R, Davalos A, Meier D, Larrue V, Bluhmki E, Davis S, Donnan G, Schneider D, Diez-Tejedor E, Trouillas P. Randomised double-blind placebo-controlled trial of thrombolytic therapy with intravenous alteplase in acute ischaemic stroke (ECASS II). Second European-Australasian Acute Stroke Study Investigators. Lancet. 1998;352(9136):1245–51.CrossRef Hacke W, Kaste M, Fieschi C, von Kummer R, Davalos A, Meier D, Larrue V, Bluhmki E, Davis S, Donnan G, Schneider D, Diez-Tejedor E, Trouillas P. Randomised double-blind placebo-controlled trial of thrombolytic therapy with intravenous alteplase in acute ischaemic stroke (ECASS II). Second European-Australasian Acute Stroke Study Investigators. Lancet. 1998;352(9136):1245–51.CrossRef
Metadaten
Titel
Delivery Assist Catheters
A new Device Class and Initial Experience in Mechanical Thrombectomy in Acute Ischemic Stroke Patients
verfasst von
Johannes A. R. Pfaff
Ralf Siekmann
Yogesh P. Shah
Peter A. Ringleb
Christian Ulfert
Kai Koller
Martin Bendszus
Markus A. Möhlenbruch
Publikationsdatum
06.09.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
Clinical Neuroradiology / Ausgabe 4/2019
Print ISSN: 1869-1439
Elektronische ISSN: 1869-1447
DOI
https://doi.org/10.1007/s00062-018-0725-x

Weitere Artikel der Ausgabe 4/2019

Clinical Neuroradiology 4/2019 Zur Ausgabe

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.