Primary aspiration thrombectomy for posterior circulation stroke

Lukas Meyer, Maria Politi, Maria Alexandrou, Michael Tepper, Andreas Kastrup, Christian Roth, Panagiotis Papanagiotou

Abstract


Purpose: Primary aspiration thrombectomy reports on posterior circulation stroke (PCS) are still rare. There- fore, we aimed to investigate the effectiveness and safety of aspiration as a first-line approach.

Material and Methods: All patients that received thrombectomy for acute ischaemic stroke with the pri- mary aspiration technique for PCS between 07/2015- 12/2018 were retrospectively analysed (n=50). In some cases stent retriever devices were used secondarily. Sta- tistical analysis was performed to identify predictors for early favourable functional outcome (modified Rankin Scale-mRS≤2) and differences between successful as- piration and secondary stent retriever use. Procedural outcomes and safety were evaluated with reference to the thrombolysis in cerebral infarction (TICI) scale, time to recanalisation, rates of symptomatic intracerebral haemorrhage (sICH), and severe adverse events related to the intervention.
Results: Primary aspiration was performed successfully in 66% (33/50) of cases. In 17 of 50 cases (34%) stent re- triever devices were used secondarily. Successful recan- alisation (TICI ≥2b) was achieved in 94% (46/50) of cases. An overall early favourable functional outcome was ob- served in 38% (19/50) of patients at discharge (mRS≤2). Compared to the secondary stent retriever group, the as- piration group showed significantly higher rates of func- tional outcome (45.5% vs. 23.5%, respectively) and suc- cessful recanalisation (TICI≥2b; 100% vs. 82.4%); a lower rate of in-hospital mortality (24% vs. 41.2%); and a faster median recanalisation time (40.5 min vs. 63 min).


Keywords


schaemic stroke; Posterior circulation; Aspiration thrombectomy

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References


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DOI: http://dx.doi.org/10.36162/hjr.v5i1.322

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