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Erschienen in: Clinical Neuroradiology 3/2018

13.02.2017 | Original Article

Maximizing First-Pass Complete Reperfusion with SAVE

verfasst von: Volker Maus, Daniel Behme, Christoph Kabbasch, Jan Borggrefe, Ioannis Tsogkas, Omid Nikoubashman, Martin Wiesmann, Michael Knauth, Anastasios Mpotsaris, Marios Nikos Psychogios

Erschienen in: Clinical Neuroradiology | Ausgabe 3/2018

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Abstract

Background

Endovascular techniques for treatment of large vessel occlusions (LVO) in patients with acute ischemic stroke (AIS) have advanced in recent years. We report a multicenter experience using a combined aspiration and stent retriever technique for mechanical thrombectomy (MT).

Methods

We retrospectively analyzed 32 consecutive MT patients using a novel, combined approach of Stent retriever Assisted Vacuum-locked Extraction (SAVE) by 3 operators at 3 stroke centers. Primary endpoint was successful first-pass reperfusion with a modified Thrombolysis in Cerebral Infarction (mTICI) score of 3. Secondary endpoints were number of passes, time from groin puncture to reperfusion, embolization to new territories (ENT), postinterventional symptomatic intracranial hemorrhage (sICH) and clinical outcome at discharge.

Results

First-pass mTICI 3 reperfusion was achieved in 23 out of 32 patients (72%) with a mean groin puncture to reperfusion time of 36.0 min ± 15.8 and mTICI 3 was accomplished in 25 out of 32 cases (78%) with a maximum of 3 attempts. Successful reperfusion (mTICI ≥ 2b) was achieved in all patients (100%) with a mean time from groin puncture to reperfusion of 44.5 min ± 25.8 and an average of 1.2 ± 0.7 attempts. The rate of ENT was 0% and 1 patient with sICH after MT died on postoperative day 4. At discharge, the median National Institutes of Health Stroke Scale (NIHSS) score was 4 (range 0−17) and favorable neurological outcome by the modified Rankin score (mRS ≤ 2) was achieved in 19 out of 32 patients (59%).

Conclusion

SAVE is fast and appears to be very effective in terms of first-pass complete reperfusion in patients with LVO.
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Metadaten
Titel
Maximizing First-Pass Complete Reperfusion with SAVE
verfasst von
Volker Maus
Daniel Behme
Christoph Kabbasch
Jan Borggrefe
Ioannis Tsogkas
Omid Nikoubashman
Martin Wiesmann
Michael Knauth
Anastasios Mpotsaris
Marios Nikos Psychogios
Publikationsdatum
13.02.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Clinical Neuroradiology / Ausgabe 3/2018
Print ISSN: 1869-1439
Elektronische ISSN: 1869-1447
DOI
https://doi.org/10.1007/s00062-017-0566-z

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