Effect of manual aspiration thrombectomy using large-bore aspiration catheter for acute basilar artery occlusion: compar
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RESEARCH ARTICLE
Open Access
Effect of manual aspiration thrombectomy using large-bore aspiration catheter for acute basilar artery occlusion: comparison with a stent retriever system Jin Wook Choi, Miran Han, Jung Hyun Park and Woo Sang Jung*
Abstract Background: A large-bore aspiration catheter can be employed for recanalization of acute basilar artery occlusion. Here we compare the results of mechanical thrombectomy using a stent retriever (SR) and manual aspiration thrombectomy (MAT) using a large-bore aspiration catheter system as a first-line recanalization method in acute basilar artery occlusion (BAO). Methods: The records of 50 patients with acute BAO who underwent mechanical thrombectomy were retrospectively reviewed. Patients were assigned to one of two groups based on the first-line recanalization method. The treatment and clinical outcomes were compared. Results: Sixteen (32%) patients were treated with MAT with a large-bore aspiration catheter and 34 (68%) with a SR as the first-line treatment method. The MAT group had a shorter procedure time (28 vs. 65 min; p = 0.001), higher rate of first-pass recanalization (68.8% vs. 38.2%, p = 0.044), and lower median number of passes (1 vs 2; p = 0.008) when compared with the SR group. There was no significant difference in the incidence of any hemorrhagic complication (6.3% vs. 8.8%; p = 0.754) between the groups. However, there were four cases of procedure-related subarachnoid hemorrhage (SAH) in the SR group and one death occurred due to massive hemorrhage. Conclusions: Selection of MAT using a large-bore aspiration catheter for acute BAO may be a safe and effective first-line treatment method with higher first-pass recanalization rate and shorter procedure time than SR. Keywords: Large-bore aspiration catheter, Manual aspiration thrombectomy, Acute basilar artery occlusion, Firstpass effect, Puncture-to-recanalization time
Background Acute basilar artery occlusion (BAO) is a rare condition, accounting for about 1% of all strokes [1]. Despite advances in acute ischemic stroke treatment recently, the prognosis remains poor with a high mortality rate in patients with BAO, especially in the absence of early reperfusion [2]. * Correspondence: [email protected] Department of Radiology, Ajou University School of Medicine, Ajou University Medical Center, Suwon, South Korea
Mechanical thrombectomy (MT) techniques have evolved rapidly in an effort to improve the rate of successful recanalization for acute ischemic stroke due to large vessel occlusion (LVO) [3–7]. The main methods of MT for LVO include stent retriever (SR) thrombectomy or manual aspiration thrombectomy (MAT) with a large-bore distal access catheter. There have been several recent studies comparing the efficacy and safety of the catheter aspiration technique and the standard stent retriever technique as a fist-line endovascular treatment in
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptati
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