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CardioVascular and Interventional Radiology

, Volume 39, Issue 7, pp 988–993 | Cite as

Stent Retriever Thrombectomy in Different Thrombus Locations of Anterior Cerebral Circulation

  • Sara Protto
  • Niko Sillanpää
  • Juha-Pekka Pienimäki
  • Ira Matkaselkä
  • Janne Seppänen
  • Heikki Numminen
Clinical Investigation

Abstract

Background

Mechanical thrombectomy (MT) is a safe and efficient treatment for acute ischemic stroke in patients with proximal anterior occlusion and large penumbra. We evaluated the technical and clinical success of MT in relation to the location of the occlusion (internal carotid artery, M1 and M2 segments of the middle cerebral artery).

Methods

We prospectively reviewed 130 patients of whom 105 met the inclusion criteria. Baseline clinical, procedural and imaging variables, technical outcome (TICI, thrombolysis in cerebral infarction), 24 h imaging outcome and three-month clinical outcome (mRS, modified Rankin Scale) were recorded. Differences between the groups were studied with statistical tests according to the type of the variable.

Results

There were 37, 46 and 22 patients in the internal carotid artery (ICA), M1 and M2 groups, respectively. TICI 2b or 3 was achieved in 92 cases (88 %) with a non-significant trend towards a better recanalization outcome in the ICA and M1 groups. Overall, 57 of the 105 patients (55 %) experienced favorable clinical outcome (mRS ≤ 2) with no significant differences between the groups. Excellent outcome (mRS ≤ 1) was seen in 40 patients (39 %) and there proportionally more patients with excellent outcome in the ICA and M1 groups (ICA: 44 %, M1: 41 %, M2: 23 % of patients, p = 0.22).

Conclusions

There were no statistically significant differences in the technical or clinical outcomes between the different sites of occlusion (ICA, M1 or M2). There was a non-significant trend towards achieving excellent clinical outcome (3-month mRS ≤ 1) more often and better recanalization results in the two more proximal locations.

Keywords

Interventional radiology Ischemic stroke Mechanical thrombectomy Stent retriever 

Abbreviations

ASPECTS

Alberta Stroke Program Early CT Score

CBV

Cerebral blood volume

COED

Cerebral oedema

ICA

Internal carotid artery

IV

Intravenous

MCA

Middle cerebral artery

MT

Mechanical thrombectomy

MTT

Mean transit time

NIHSS

National Institutes of Health Stroke Scale

TICI

Thrombolysis in cerebral infarction

Notes

Acknowledgments

The authors would like to thank Jyrki Ollikainen, MD, for clinical insights in preparing the manuscript. This study was financially supported by the Competitive State Research Financing of the Expert Responsibility Area of Tampere University Hospital (Grant 9S061).

Compliance with Ethical Standards

Conflict of Interest

All authors declare that they have no conflicts of interest relevant to this manuscript.

Ethical Standards

All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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Copyright information

© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2016

Authors and Affiliations

  • Sara Protto
    • 2
  • Niko Sillanpää
    • 2
  • Juha-Pekka Pienimäki
    • 2
  • Ira Matkaselkä
    • 2
  • Janne Seppänen
    • 2
  • Heikki Numminen
    • 1
  1. 1.Department of NeurologyTampere University HospitalTampereFinland
  2. 2.Medical Imaging CenterTampere University HospitalTampereFinland

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