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Carotid Elongation Does Not Affect Angiographic Results of Mechanical Thrombectomy in Acute Stroke

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Summary

Background and Purpose

New techniques have substantially raised recanalization rates of mechanical thrombectomy in acute ischemic stroke in the last few years with initial prospective trials reporting good neurological outcome in up to 58 % of the cases. However some recent reports questioning the benefit of endovascular therapy have initiated a discussion about the importance of patient-selection. The purpose of this study was to investigate whether an elongation of the carotid artery affects the angiographic outcome of the recanalization procedure in middle cerebral artery (MCA)-occlusions.

Materials and Methods

The data of 54 patients with occlusions of the M1-segment who underwent mechanical thrombectomy were included. The lengths of the carotid arteries were measured using preinterventional computed tomography (CT)-angiograms. To take individual patient’s height into account these lengths were divided by the length of the spine from the tip of the dens to the bottom of the th3 vertebral body (referred to as carotid-to-spine (CS)-Ratio). Angiographic results were scored according to the modified thrombolysis in cerebral infarction (mTICI)-score.

Results

Recanalization with mTICI ≥ 2b was achieved in 83.3 %. The mean CS-Ratio was 1.32 ± 0.13. There was a significant correlation between the CS-Ratio and the age of the patients. There were no significant differences in the CS-Ratios of occlusions that were successfully recanalized and those that were not. Neither were there significant correlations of the CS-Ratio and the length of procedure or the number of deployments of the stentretrievers.

Conclusion

In this retrospective analysis we report that carotid elongation does not affect angiographic results of mechanical thrombectomy in acute stroke.

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Conclusions

In this retrospective analysis we report that carotid elongation does not affect angiographic results of mechanical thrombectomy in acute stroke and, therefore, should not be used as a criterion for patient-selection for endovascular treatment. Our results affirm that mechanical thrombectomy with stentretrievers is a method with stable angiographic results even in difficult anatomic conditions.

Conflict of Interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Neuroradiology, Saarland University Hospital, Kirrberger Str., 66424, Homburg, Germany

    Umut Yilmaz MD, Ruben Mühl-Benninghaus MD, Andreas Simgen, Wolfgang Reith MD & Heiko Körner MD

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  1. Umut Yilmaz MD
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  2. Ruben Mühl-Benninghaus MD
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  3. Andreas Simgen
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  4. Wolfgang Reith MD
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  5. Heiko Körner MD
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Correspondence to Umut Yilmaz MD.

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Yilmaz, U., Mühl-Benninghaus, R., Simgen, A. et al. Carotid Elongation Does Not Affect Angiographic Results of Mechanical Thrombectomy in Acute Stroke. Clin Neuroradiol 26, 183–187 (2016). https://doi.org/10.1007/s00062-014-0345-z

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  • DOI: https://doi.org/10.1007/s00062-014-0345-z

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