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Neurointervention > Volume 18(1); 2023 > Article |
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Ethics Statement
Ethics approval was obtained from the Institutional Review Board of California Pacific Medical Center (approved protocol 2.16.17). Due to the retrospective nature of the study, the need for patient informed consent was waived. As any information such as sex or age is not included, Informed consent for publication is not required.
Conflicts of Interest
FS reports consulting fees, grant, and honoraria from Stryker; consulting fees from Route 92 Medical; grant from MicroVention. WTK reports an equity interest in and consulting fees from Route 92 Medical, as well as consulting fees from Stryker. JDE reports an equity interest in and consulting fees from Route 92 Medical, as well as consulting fees from Stryker.
Author Contributions
Concept and design: FS. Analysis and interpretation: FS, WTK, and JDE. Data collection: FS and JDE. Writing the article: FS. Critical revision of the article: FS, WTK, and JDE. Final approval of the article: FS, WTK, and JDE. Statistical analysis: FS. Overall responsibility: FS.
Case no. | NIHSS | IV-tPA | Location of LVO | Initial mTICI score | Final mTICI score | Time from groin puncture to reperfusion, minutes | Discharge NIHSS | Technique | Number of passes |
---|---|---|---|---|---|---|---|---|---|
1 | 4 | No | Proximal L M2 | 2A | 2C | 68 | 1 | Combination: Trevo XP 4x20+Vecta 71 | 4 |
2 | 16 | Yes | R M1 | 0 | 2C | 8 | 7 | Combination: Trevo XP 6x30+Vecta 71 | 2 |
3 | 11 | No | Proximal R M2 | 2A | 2C | 17 | 0 | ADAPT: Vecta 71 | 2 |
4 | 15 | No | R M1 | 0 | 3 | 59 | 6 | ADAPT: Vecta 74 | 1 |
5 | 9 | No | Proximal L M2 | 2A | 3 | 29 | 3 | ADAPT: Vecta 71 | 4 |
6 | 20 | Yes | Proximal L M2 | 2A | 3 | 33 | 2 | ADAPT: Vecta 71 | 2 |
7 | 27 | No | Proximal R M2 | 2A | 3 | 11 | * | ADAPT: Vecta 71 | 1 |
8 | 5 | Yes | R M1 | 0 | 0 | NA | 20 | ADAPT: Vecta 71 | 2 |
9 | 24 | Yes | L ICA-T | 0 | 2C | 13 | 9 | ADAPT: Vecta 74 | 1 |
NIHSS, National Institutes of Health Stroke Scale; IV-tPA, intravenous tissue plasminogen activator; LVO, large vessel occlusion; mTICI, modified thrombolysis in cerebral ischemia score; L, left; R, right; ICA-T, internal carotid artery terminus occlusion; NA, not available; ADAPT, a direct aspiration first pass technique.
Demographics and procedural data |
Reference study |
||
---|---|---|---|
Gross et al. [31] (2019) | Almallouhi et al. [34] (2019) | Current study | |
Catheter used | Vecta 71 | Vecta 71 | Vecta 71 and 74 |
No. of patients | 19 | 10 | 9 |
Median/mean age | NR | 76.2 (5.83) | 68 (IQR 60–74) |
Sex, female | NR | 4/10 | 4/9 |
Baseline non-contrast CT ASPECTS | NR | 7.5 (IQR 7–8.75) | 7 (IQR 5–9) |
IV thrombolytic | 1/19 | 9/10 | 4/9 |
Occlusion location | |||
ICA | 6/19 (32) | 0/10 | 1/9 |
M1 | 11/19 (58) | 4/10 | 3/9 |
Proximal M2 | 0/19 | 6/10 | 5/9 |
Basilar | 2/19 (11) | 0/10 | 0/9 |
Technique | |||
Catheter reached clot | 19/19 (100) | 9/10 | 9/9 (100) |
Stentriever needed to reach clot | 1/19 (5) | 0/10 | 2/9 (22) |
Empiric stentriever used | 5/19 (26) | 0/10 | 2/9 (22) |
Catheter reached clot, no stentriever | 13/14 (93) | 9/10 | 7/9 (78) |
Mean/median number of passes | 2.6 (2.0) | 2 | 2 passes (IQR 1–2) |
Single pass cases | 8/19 (42) | NR | 3/9 (33) |
Mean/median procedural time (min) | 42 (32) | 29.5 (IQR 14.3–53.3) | 23 (IQR 12.5–32) |
FPE (mTICI 2b–3) | 9/19 (47) | NR | |
FPE (mTICI 2c–3) | NR | NR | |
Successful recanalization (mTICI 2b-3) | 17/19 (89) | 9/10 (90) | 8/9 (89) |
Complete recanalization (mTICI 2c–3) | NR | 4/10 | 8/9 (89) |
Complications | 2/19 (11) | 0 | 0 |
Mean improvement in NIHSS, post-procedural day 1 | 8 (7.0) | NR | NR |
Mean/median improvement in NIHSS at discharge | NR | 9.9 (4.9) | 9 (IQR 5–12) |
Mortality within available follow-up period | 6/19 (32) | NR | 1/9 |
Values are presented as number only or number (%).
CT, computed tomography; ASPECTS, Alberta stroke program early CT score; IV, intravenous; ICA, internal carotid artery; FPE, first pass effect; mTICI, modified treatment in cerebral ischemia; NIHSS, National Institutes of Health Stroke Scale; NR, not reported; IQR, interquartile range.
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