Update on Thrombectomy

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: 27 June 2024 | Viewed by 507

Special Issue Editor


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Guest Editor
Director of the Chair of Interventional Neuroradiology, University of Santiago de Compostela, Santiago de Compostela University, A Coruña, Spain
Interests: hemorrhagic stroke; ischemic stroke; brain aneurysms; thrombectomy; flow diverters

Special Issue Information

Dear Colleagues,

Endovascular thrombectomy (EVT) has been validated in several randomized controlled trials in recent years for its efficacy in the treatment of acute ischemic strokes (AIS). It is now the standard of care according to international guidelines (level 1 class A evidence).

Since 2015, there have been significant advances in establishing and widening the criteria for treatment. However, in about 20% of EVT procedures, recanalization is not achieved, and over 50% of patients who undergo EVT still do not have good functional outcomes.

This Special Issue aims to summarize the current evidence base and the latest advances with interest in recanalization treatments for acute ischemic stroke. It focuses on improving thrombectomy techniques, including the development of new technologies and new systems as well as the expansion of their indications to distal arteries and posterior territory.

Prof. Dr. José Manuel Pumar
Guest Editor

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Keywords

  • first pass recanalization
  • thrombectomy distal arteries
  • thrombectomy posterior territory
  • direct aspiration vs. stent retriever
  • combined techniques
  • cyclical aspiration
  • rescue stenting

Published Papers (1 paper)

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10 pages, 244 KiB  
Article
Enhancing the First-Pass Effect in Acute Stroke: The Impact of Stent Retriever Characteristics
by Eduardo Murias, Josep Puig, Carmen Serna-Candel, Eva María Gonzalez, Manuel Moreu, Elvira Jiménez-Gómez, Luis SanRoman, Fernando Aparici-Robles, Mikel Terceño, Antonio Mosqueira Martínez, Sonia Aixut, Veredas Romero, Jose Carlos Mendez, Antonio Sagredo-Barra, Yeray Aguilar, Mariano Espinosa de Rueda, Miguel Angel Castaño Blázquez, Saima Bashir, José Rodríguez Castro, Alfonso Lopez-Frías, Jose María Jiménez, Juan Chaviano, Victor Maestro, Javier Manso, Antonio Lopez-Rueda, Sebastià Remollo, Lluis Morales-Caba, Marc Comas-Cufí, Pedro Vega and on behalf of Rossetti Registry Investigatorsadd Show full author list remove Hide full author list
J. Clin. Med. 2024, 13(11), 3123; https://doi.org/10.3390/jcm13113123 - 26 May 2024
Viewed by 296
Abstract
Introduction: Although stentrievers (SRs) have been a mainstay of mechanical thrombectomy (MT), and current guidelines recommend the use of SRs in the treatment of large vessel occlusion stroke (LVO), there is a paucity of studies in the literature comparing SRs directly against each [...] Read more.
Introduction: Although stentrievers (SRs) have been a mainstay of mechanical thrombectomy (MT), and current guidelines recommend the use of SRs in the treatment of large vessel occlusion stroke (LVO), there is a paucity of studies in the literature comparing SRs directly against each other in terms of mechanical and functional properties. Timely access to endovascular therapy and the ability to restore intracranial flow in a safe, efficient, and efficacious manner have been critical to the success of MT. This study aimed to investigate the impact of contemporary SR characteristics, including model, brand, size, and length, on the first-pass effect (FPE) in patients with acute ischemic stroke. Methods: Consecutive patients with M1 occlusion treated with a single SR+BGC were recruited from the ROSSETTI registry. The primary outcome was the FPE that was defined as modified (mFPE) or true (tFPE) for the achievement of modified thrombolysis in cerebral infarction (mTICI) grades 2b-3 or 3 after a single device pass, respectively. We compared patients who achieved mFPE with those who achieved tFPE according to SR characteristics. Results: We included 610 patients (52.3% female and 47.7% male, mean age 75.1 ± 13.62 years). mFPE was achieved in 357 patients (58.5%), whereas tFPE was achieved in 264 (43.3%). There was no significant association between SR characteristics and mFPE or tFPE. Specifically, the SR size did not show a statistically significant relationship with improvement in FPE. Similarly, the length of the SR did not yield significant differences in the mFPE and tFPE, even when the data were grouped. Conclusions: Our data indicate that contemporary SR-mediated thrombectomy characteristics, including model, brand, size, and length, do not significantly affect the FPE. Full article
(This article belongs to the Special Issue Update on Thrombectomy)
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