Ces radiol. 2018, 72(2):84-89 | DOI: 10.55095/CesRadiol2018/014

Comparison of the technical results of endovascular treatment of ischemic stroke with use of 4 and 6 mm stentrieverOriginal article

Filip Cihlář¹, Vojtěch Šmolka¹, David Černík², Jan Svoboda¹, Jiří Cihlář³

¹ Radiologická klinika Fakulty zdravotnických studií UJEP a Krajské zdravotní a.s., Masarykovy nemocnice v Ústí nad Labem, o.z.

² Neurologické oddělení, Krajská zdravotní a.s., Masarykova nemocnice o.z., Ústí nad Labem

³ Katedra matematiky, Přírodovědecká fakulta, Univerzita J. E. Purkyně, Ústí nad Labem

Objective: To evaluace a cohort of patiens who underwent stentriever-based mechanical tromboectomy with special focus on technical results of endovascular treatment.

Methods: Our cohort consisted of 237 consecutive patients who were treated for acute ischemic stroke in 2016-2017. Out of this number, 176 patients were treated endovascularly with balloon-guiding catheter and stentriever. We retrospectively evaluated the degree of recanalization achieved, when using 4 mm or 6 mm stentrievers. Data on intervals from ischemia to recanalization, the duration of endovascular surgery and the number of retractions of stentriever were noted as well as periprocedural complications, such as vessel perforation and symptomatic intracerebral haemorrhage (SICH).

Results: In the observed period, 122 embolectomies were performed using 4 mm stentriever and 54 embolectomies with 6 mm. The technical success rate was 79.51% for 4 mm size and 90.74% for 6 mm size, respectively (p = 0.068). There was no difference in time intervals from onset of the stroke to recanalization (272.6 ± 159.7 min vs. 262.2 ± 133.3 min, p = 0.463), in time from groin puncture to first retraction (26.9 ± 25.3 min vs. 31.1 ± 25.9 min, p = 0.305) and in duration of procedure (55.4 ± 33.3 min vs. 60.2 ± 30.6 min, p = 0.205). In a subset of 95 patients treated for occlusion of a. cerebri media, the technical success rate was 75.61 % and 100 %, resp. (p = 0.045). Four perforations and three SICH occured in the 4 mm stentriever group. In the group treated with 6 mm stentriver no complications were noted.

Conclusion: Our results support the hypothesis that a 6mm stentriever can achieve a higher degree of successful recanalization compared to a 4mm size while maintaining procedure safety. Using 6 mm stentriver did not result in better recanalization times.

Keywords: mechanical thrombectomy, stentriever, ischemic stroke, recanalization

Grants and funding:

Vznik práce byl podpořen grantem IGA-KZ-2017-1-2.

Accepted: April 10, 2018; Published: June 1, 2018  Show citation