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Clinical Neuroradiology

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22.12.2022 | Original Article

Possible Contribution of the Aspiration Catheter in Preventing Post-stent Retriever Thrombectomy Subarachnoid Hemorrhage

verfasst von: Yasuhiko Nariai, Tomoji Takigawa, Yosuke Kawamura, Akio Hyodo, Kensuke Suzuki

Erschienen in: Clinical Neuroradiology | Ausgabe 2/2023

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Abstract

Purpose

This study aimed to identify factors related to the incidence of post-thrombectomy subarachnoid hemorrhage (PTSAH).

Methods

This retrospective, observational cohort study enrolled consecutive patients with acute ischemic stroke (AIS) due to the internal carotid artery (IC) top or middle cerebral artery (MCA) M1 or M2 segment occlusion who underwent single-pass stent retriever (SR) treatment between January 2015 and May 2022 at two acute care hospitals.

Results

Of the 54 included patients, 10 were in the PTSAH group (18.5%). The occlusion sites were IC top (31.5%), M1 segment (48.1%), and M2 segment (20.4%). Aspiration catheters (ACs) were used in 32 (59.3%) patients; however, the combined technique (AC advancement at least to the most proximal marker of SR) was actually used in 26 (48.1%) patients because a ledge effect at the ophthalmic artery origin from the IC interfered with distal navigation of the ACs. The baseline patient characteristics did not differ between the groups. M2 segment occlusion in the PTSAH and non-PTSAH groups were 40.0% and 15.9%, respectively (p = 0.19). More ACs were used in the non-PTSAH group (65.9% vs. 30.0%, p = 0.07). Significantly fewer combined techniques were performed in the PTSAH group (10.0% vs. 56.8%, p = 0.01). In multivariate analysis adjusted by variables with M2 segment occlusion and the combined technique, the combined technique (odds ratio 0.098; 95% confidence interval, 0.011–0.887; p = 0.039) was identified as a significantly associated factor for PTSAH. There was one PTSAH case (1.9%) with symptom worsening.

Conclusion

The combined technique significantly influenced PTSAH occurrence as a preventive factor.

Barral M, Boudour S, Viprey M, Giroudon C, Aulagner G, Schott AM, Turjman F, Armoiry X, Gory B. Stent retriever thrombectomy for acute ischemic stroke: A systematic review and meta-analysis of randomized controlled trials, including THRACE. Rev Neurol (Paris). 2018;174:319–26.CrossRefPubMed

Nogueira RG, Lutsep HL, Gupta R, Jovin TG, Albers GW, Walker GA, Liebeskind DS, Smith WS; TREVO 2 Trialists. Trevo versus Merci retrievers for thrombectomy revascularisation of large vessel occlusions in acute ischaemic stroke (TREVO 2): a randomised trial. Lancet. 2012;380:1231–40. Erratum in: Lancet. 2012;380:1230.CrossRefPubMedPubMedCentral

Gascou G, Lobotesis K, Machi P, Maldonado I, Vendrell JF, Riquelme C, Eker O, Mercier G, Mourand I, Arquizan C, Bonafé A, Costalat V. Stent retrievers in acute ischemic stroke: complications and failures during the perioperative period. AJNR Am J Neuroradiol. 2014;35:734–40.CrossRefPubMedPubMedCentral

Bracard S, Ducrocq X, Mas JL, Soudant M, Oppenheim C, Moulin T, Guillemin F; THRACE investigators. Mechanical thrombectomy after intravenous alteplase versus alteplase alone after stroke (THRACE): a randomised controlled trial. Lancet Neurol. 2016;15:1138–47. Erratum in: Lancet Neurol. 2016;15:1203.CrossRefPubMed

Balami JS, White PM, McMeekin PJ, Ford GA, Buchan AM. Complications of endovascular treatment for acute ischemic stroke: Prevention and management. Int J Stroke. 2018;13:348–61.CrossRefPubMed

Goyal M, Menon BK, van Zwam WH, Dippel DW, Mitchell PJ, Demchuk AM, Dávalos A, Majoie CB, van der Lugt A, de Miquel MA, Donnan GA, Roos YB, Bonafe A, Jahan R, Diener HC, van den Berg LA, Levy EI, Berkhemer OA, Pereira VM, Rempel J, Millán M, Davis SM, Roy D, Thornton J, Román LS, Ribó M, Beumer D, Stouch B, Brown S, Campbell BC, van Oostenbrugge RJ, Saver JL, Hill MD, Jovin TG; HERMES collaborators. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet. 2016;387:1723–31.CrossRefPubMed

Campbell BC, Mitchell PJ, Kleinig TJ, Dewey HM, Churilov L, Yassi N, Yan B, Dowling RJ, Parsons MW, Oxley TJ, Wu TY, Brooks M, Simpson MA, Miteff F, Levi CR, Krause M, Harrington TJ, Faulder KC, Steinfort BS, Priglinger M, Ang T, Scroop R, Barber PA, McGuinness B, Wijeratne T, Phan TG, Chong W, Chandra RV, Bladin CF, Badve M, Rice H, de Villiers L, Ma H, Desmond PM, Donnan GA, Davis SM; EXTEND-IA Investigators. Endovascular therapy for ischemic stroke with perfusion-imaging selection. N Engl J Med. 2015;372:1009–18.CrossRefPubMed

Enomoto Y, Yoshimura S, Egashira Y, Takagi T, Tsujimoto M, Iwama T. Long-term magnetic resonance angiography follow-up for recanalized vessels after mechanical thrombectomy. J Stroke Cerebrovasc Dis. 2014;23:2834–9.CrossRefPubMed

Goyal M, Demchuk AM, Menon BK, Eesa M, Rempel JL, Thornton J, Roy D, Jovin TG, Willinsky RA, Sapkota BL, Dowlatshahi D, Frei DF, Kamal NR, Montanera WJ, Poppe AY, Ryckborst KJ, Silver FL, Shuaib A, Tampieri D, Williams D, Bang OY, Baxter BW, Burns PA, Choe H, Heo JH, Holmstedt CA, Jankowitz B, Kelly M, Linares G, Mandzia JL, Shankar J, Sohn SI, Swartz RH, Barber PA, Coutts SB, Smith EE, Morrish WF, Weill A, Subramaniam S, Mitha AP, Wong JH, Lowerison MW, Sajobi TT, Hill MD; ESCAPE Trial Investigators. Randomized assessment of rapid endovascular treatment of ischemic stroke. N Engl J Med. 2015;372:1019–30.CrossRefPubMed

10.

Jovin TG, Chamorro A, Cobo E, de Miquel MA, Molina CA, Rovira A, San Román L, Serena J, Abilleira S, Ribó M, Millán M, Urra X, Cardona P, López-Cancio E, Tomasello A, Castaño C, Blasco J, Aja L, Dorado L, Quesada H, Rubiera M, Hernandez-Pérez M, Goyal M, Demchuk AM, von Kummer R, Gallofré M, Dávalos A; REVASCAT Trial Investigators. Thrombectomy within 8 hours after symptom onset in ischemic stroke. N Engl J Med. 2015;372:2296–306.CrossRefPubMed

11.

Kleine JF, Wunderlich S, Zimmer C, Kaesmacher J. Time to redefine success? TICI 3 versus TICI 2b recanalization in middle cerebral artery occlusion treated with thrombectomy. J Neurointerv Surg. 2017;9:117–21.CrossRefPubMed

12.

Pilgram-Pastor SM, Piechowiak EI, Dobrocky T, Kaesmacher J, Den Hollander J, Gralla J, Mordasini P. Stroke thrombectomy complication management. J Neurointerv Surg. 2021;13:912–7.CrossRefPubMedPubMedCentral

13.

Saver JL, Goyal M, Bonafe A, Diener HC, Levy EI, Pereira VM, Albers GW, Cognard C, Cohen DJ, Hacke W, Jansen O, Jovin TG, Mattle HP, Nogueira RG, Siddiqui AH, Yavagal DR, Baxter BW, Devlin TG, Lopes DK, Reddy VK, du Mesnil de Rochemont R, Singer OC, Jahan R; SWIFT PRIME Investigators. Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke. N Engl J Med. 2015;372:2285–95.CrossRefPubMed

14.

Kurre W, Aguilar-Pérez M, Martinez-Moreno R, Schmid E, Bäzner H, Henkes H. Stent Retriever Thrombectomy of Small Caliber Intracranial Vessels Using pREset LITE: Safety and Efficacy. Clin Neuroradiol. 2017;27:351–60.CrossRefPubMed

15.

Yoon W, Jung MY, Jung SH, Park MS, Kim JT, Kang HK. Subarachnoid hemorrhage in a multimodal approach heavily weighted toward mechanical thrombectomy with solitaire stent in acute stroke. Stroke. 2013;44:414–9.CrossRefPubMed

16.

Peschillo S, Diana F, Berge J, Missori P. A comparison of acute vascular damage caused by ADAPT versus a stent retriever device after thrombectomy in acute ischemic stroke: a histological and ultrastructural study in an animal model. J Neurointerv Surg. 2017;9:743–9.CrossRefPubMed

17.

Machi P, Jourdan F, Ambard D, Reynaud C, Lobotesis K, Sanchez M, Bonafé A, Costalat V. Experimental evaluation of stent retrievers’ mechanical properties and effectiveness. J Neurointerv Surg. 2017;9:257–63.CrossRefPubMed

18.

Peschillo S, Tomasello A, Diana F, Hernandez D, Toccaceli G, Rosal-Fontana M, Esteves Coelho M, Missori P. Comparison of Subacute Vascular Damage Caused by ADAPT versus Stent Retriever Devices after Thrombectomy in Acute Ischemic Stroke: Histological and Ultrastructural Study in an Animal Model. Interv Neurol. 2018;7:501–12.CrossRefPubMedPubMedCentral

19.

Ng PP, Larson TC, Nichols CW, Murray MM, Salzman KL, Smith RH. Intraprocedural predictors of post-stent retriever thrombectomy subarachnoid hemorrhage in middle cerebral artery stroke. J Neurointerv Surg. 2019;11:127–32.CrossRefPubMed

20.

Goto S, Ohshima T, Ishikawa K, Yamamoto T, Shimato S, Nishizawa T, Kato K. A Stent-Retrieving into an Aspiration Catheter with Proximal Balloon (ASAP) Technique: A Technique of Mechanical Thrombectomy. World Neurosurg. 2018;109:e468–75.CrossRefPubMed

21.

Baharvahdat H, Ooi YC, Khatibi K, Ponce Mejia LL, Kaneko N, Nour M, Szeder V, Jahan R, Tateshima S, Vinuela F, Duckwiler G, Colby G. Increased Rate of Successful First Passage Recanalization During Mechanical Thrombectomy for M2 Occlusion. World Neurosurg. 2020;139:e792–9.CrossRefPubMed

22.

Shirakawa M, Yoshimura S, Uchida K, Shindo S, Yamada K, Kuroda J, Takagi T, Takada Y, Ishikura R. Relationship between Hemorrhagic Complications and Target Vessels in Acute Thrombectomy. J Stroke Cerebrovasc Dis. 2017;26:1732–8.CrossRefPubMed

23.

Fiorelli M, Bastianello S, von Kummer R, del Zoppo GJ, Larrue V, Lesaffre E, Ringleb AP, Lorenzano S, Manelfe C, Bozzao L. Hemorrhagic transformation within 36 hours of a cerebral infarct: relationships with early clinical deterioration and 3-month outcome in the European Cooperative Acute Stroke Study I (ECASS I) cohort. Stroke. 1999;30:2280–4.CrossRefPubMed

24.

McTaggart RA, Ospel JM, Psychogios MN, Puri AS, Maegerlein C, Lane KM, Jayaraman MV, Goyal M. Optimization of Endovascular Therapy in the Neuroangiography Suite to Achieve Fast and Complete (Expanded Treatment in Cerebral Ischemia 2c-3) Reperfusion. Stroke. 2020;51:1961–8.CrossRefPubMed

25.

McTaggart RA, Tung EL, Yaghi S, Cutting SM, Hemendinger M, Gale HI, Baird GL, Haas RA, Jayaraman MV. Continuous aspiration prior to intracranial vascular embolectomy (CAPTIVE): a technique which improves outcomes. J Neurointerv Surg. 2017;9:1154–9.CrossRefPubMed

26.

Ohshima T, Miyachi S. A novel technique for mitigation of the ledge effect caused by the use of a large-lumen catheter during neurointervention: beanstalk method. Asian J Neurosurg. 2020;15:753–5.CrossRefPubMedPubMedCentral

27.

Committee of the Japan Diabetes Society on the Diagnostic Criteria of Diabetes Mellitus, Seino Y, Nanjo K, Tajima N, Kadowaki T, Kashiwagi A, Araki E, Ito C, Inagaki N, Iwamoto Y, Kasuga M, Hanafusa T, Haneda M, Ueki K. Report of the committee on the classification and diagnostic criteria of diabetes mellitus. J Diabetes Investig. 2010;1:212–28.CrossRefPubMedPubMedCentral

28.

Minematsu K, Toyoda K, Hirano T, Kimura K, Kondo R, Mori E, Nakagawara J, Sakai N, Shiokawa Y, Tanahashi N, Yasaka M, Katayama Y, Miyamoto S, Ogawa A, Sasaki M, Suga S, Yamaguchi T; Japan Stroke Society. Guidelines for the intravenous application of recombinant tissue-type plasminogen activator (alteplase), the second edition, October 2012: a guideline from the Japan Stroke Society. J Stroke Cerebrovasc Dis. 2013;22:571–600.CrossRefPubMed

29.

Teo YN, Sia CH, Tan BYQ, Mingxue J, Chan B, Sharma VK, Makmur A, Gopinathan A, Yang C, Loh S, Ng S, Ong SJ, Teoh HL, Rathakrishnan R, Andersson T, Arnberg F, Gontu VK, Lee TH, Maus V, Meyer L, Bhogal P, Spooner O, Li TY, Soh RY, Yeo LL. Combined balloon guide catheter, aspiration catheter, and stent retriever technique versus balloon guide catheter and stent retriever alone technique: a systematic review and meta-analysis. J Neurointerv Surg. 2022. https://doi.org/10.1136/neurintsurg-2021-018406. Epub ahead of print.CrossRefPubMed

30.

Texakalidis P, Bekelis K, Atallah E, Tjoumakaris S, Rosenwasser RH, Jabbour P. Flow diversion with the pipeline embolization device for patients with intracranial aneurysms and antiplatelet therapy: A systematic literature review. Clin Neurol Neurosurg. 2017;161:78–87.CrossRefPubMed

31.

Schartz DA, Ellens NR, Kohli GS, Akkipeddi SMK, Colby GP, Bhalla T, Mattingly TK, Bender MT. A Meta-analysis of Combined Aspiration Catheter and Stent Retriever versus Stent Retriever Alone for Large-Vessel Occlusion Ischemic Stroke. AJNR Am J Neuroradiol. 2022;43:568–74.CrossRefPubMedPubMedCentral

32.

Okuda T, Arimura K, Matsuo R, Tokunaga S, Hara K, Yamaguchi S, Yoshida H, Kurogi R, Kameda K, Ito O, Tsumoto T, Iihara K, Mizokami T, Uwatoko T, Nishimura A, Iwaki K, Mizoguchi M; QNET investigators. Efficacy of combined use of a stent retriever and aspiration catheter in mechanical thrombectomy for acute ischemic stroke. J Neurointerv Surg. 2022;14:892–7.CrossRefPubMed

33.

Texakalidis P, Giannopoulos S, Karasavvidis T, Rangel-Castilla L, Rivet DJ, Reavey-Cantwell J. Mechanical Thrombectomy in Acute Ischemic Stroke: A Meta-Analysis of Stent Retrievers vs Direct Aspiration vs a Combined Approach. Neurosurgery. 2020;86:464–77.CrossRefPubMed

34.

Zhang Y, Zhang Y, Hu C, Zhao W, Zhang Z, Li W. A direct aspiration first-pass technique (ADAPT) versus stent retriever for acute ischemic stroke (AIS): a systematic review and meta-analysis. J Neurol. 2021;268:4594–606.CrossRefPubMed

35.

Baek SH, Kim S, Kang M, Choi JH, Kwon HJ, Kim DW. Effect of distal access catheter tip position on angiographic and clinical outcomes following thrombectomy using the combined stent-retriever and aspiration approach. PLoS One. 2021;16:e0252641.CrossRefPubMedPubMedCentral

36.

Ohshima T, Miyachi S. Experimental Evaluation of the Risk of Distal Embolization during Endovascular Clot Retrieval Using Various Techniques. Asian J Neurosurg. 2021;16:84–8.CrossRefPubMedPubMedCentral

37.

Haussen DC, Al-Bayati AR, Grossberg JA, Bouslama M, Barreira C, Bianchi N, Frankel MR, Nogueira RG. Longer stent retrievers enhance thrombectomy performance in acute stroke. J Neurointerv Surg. 2019;11:6–8.CrossRefPubMed

38.

Sarraj A, Sangha N, Hussain MS, Wisco D, Vora N, Elijovich L, Goyal N, Abraham M, Mittal M, Feng L, Wu A, Janardhan V, Nalluri S, Yoo AJ, George M, Edgell R, Shah RJ, Sitton C, Supsupin E, Bajgur S, Denny MC, Chen PR, Dannenbaum M, Martin-Schild S, Savitz SI, Gupta R. Endovascular Therapy for Acute Ischemic Stroke With Occlusion of the Middle Cerebral Artery M2 Segment. JAMA Neurol. 2016;73:1291–6.CrossRefPubMed

39.

Ospel JM, Goyal M. A review of endovascular treatment for medium vessel occlusion stroke. J Neurointerv Surg. 2021;13:623–30.CrossRefPubMed

40.

Kurre W, Pérez MA, Horvath D, Schmid E, Bäzner H, Henkes H. Does mechanical thrombectomy in acute embolic stroke have long-term side effects on intracranial vessels? An angiographic follow-up study. Cardiovasc Intervent Radiol. 2013;36:629–36.CrossRefPubMed

Titel: Possible Contribution of the Aspiration Catheter in Preventing Post-stent Retriever Thrombectomy Subarachnoid Hemorrhage
verfasst von: Yasuhiko Nariai
Tomoji Takigawa
Yosuke Kawamura
Akio Hyodo
Kensuke Suzuki
Publikationsdatum: 22.12.2022
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Neuroradiology / Ausgabe 2/2023
Print ISSN: 1869-1439
Elektronische ISSN: 1869-1447
DOI: https://doi.org/10.1007/s00062-022-01240-4

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Possible Contribution of the Aspiration Catheter in Preventing Post-stent Retriever Thrombectomy Subarachnoid Hemorrhage

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Conclusion

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