Comparison of mechanical thrombectomy with contact aspiration, stent retriever, and combined procedures in patients with large-vessel occlusion in acute ischemic stroke
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F61989100%3A27240%2F18%3A10240666" target="_blank" >RIV/61989100:27240/18:10240666 - isvavai.cz</a>
Alternative codes found
RIV/00843989:_____/18:E0107404
Result on the web
<a href="https://www.medscimonit.com/abstract/index/idArt/913458" target="_blank" >https://www.medscimonit.com/abstract/index/idArt/913458</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.12659/MSM.913458" target="_blank" >10.12659/MSM.913458</a>
Alternative languages
Result language
angličtina
Original language name
Comparison of mechanical thrombectomy with contact aspiration, stent retriever, and combined procedures in patients with large-vessel occlusion in acute ischemic stroke
Original language description
Background: We investigated the properties and effects of 5 mechanical thrombectomy procedures in patients with acute ischemic stroke. The relationships between the type of procedure, the time required, the success of recanalization, and the clinical outcome were analyzed. Material/Methods: This prospective comparative analysis included 500 patients with acute ischemic stroke and large-vessel occlusion. We compared contact aspiration thrombectomy (ADAPT, n=100), stent retriever first line (SRFL, n=196), the Solumbra technique (n=64), mechanical thrombectomy plus stent implantation (n=81), and a combined procedure (n=59). Results: ADAPT provided shorter procedure (P<0.001) and recanalization times (P<0.001) than the other techniques. Better clinical outcome was achieved for ischemia in the anterior circulation than ischemia in the posterior fossa (P<0.001). Compared to the other techniques, patients treated with ADAPT procedure had increased odds of achieving better mTICI scores (P=0.002) and clinical outcome (NIHSS) after 7 days (P=0.003); patients treated with SRFL had increased odds of achieving better long-term clinical status (3M-mRS=0-2; P=0.040). Patients with SRFL and intravenous thrombolysis (IVT) had increased odds of better clinical status (3M-mRS=0-2; P=0.031) and decreased odds of death (P=0.005) compared to patients with SRFL without IVT. The other treatment approaches had no additional effect of IVT. Patients with SRFL with a mothership transfer had increased odds of achieving favorable clinical outcome (3M-mRS) compared to SRFL with the drip-and-ship transfer paradigm (P=0.015). Conclusions: Our results showed that ADAPT and SRFL provided significantly better outcomes compared to the other examined techniques. A mothership transfer and IVT administration contributed to the success of the SRFL approach. (C) Med Sci Monit, 2018.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30210 - Clinical neurology
Result continuities
Project
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Continuities
S - Specificky vyzkum na vysokych skolach
Others
Publication year
2018
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
Medical Science Monitor
ISSN
1234-1010
e-ISSN
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Volume of the periodical
24
Issue of the periodical within the volume
22.12.2018
Country of publishing house
US - UNITED STATES
Number of pages
12
Pages from-to
9342-9353
UT code for WoS article
000454280800003
EID of the result in the Scopus database
2-s2.0-85058924192