Header

UZH-Logo

Maintenance Infos

Experimental evaluation of direct thromboaspiration efficacy according to the angle of interaction between the aspiration catheter and the clot


Bernava, Gianmarco; Rosi, Andrea; Boto, José; Hofmeister, Jeremy; Brina, Olivier; Reymond, Philippe; Muster, Michel; Yilmaz, Hasan; Kulcsar, Zsolt; Carrera, Emmanuel; Bouri, Mohamed; Lovblad, Karl-Olof; Machi, Paolo (2021). Experimental evaluation of direct thromboaspiration efficacy according to the angle of interaction between the aspiration catheter and the clot. Journal of NeuroInterventional Surgery:Epub ahead of print.

Abstract

BACKGROUND

Successful direct thromboaspiration (DTA) is related to several factors such as clot consistency, size, and location. It has also been demonstrated recently that the angle of interaction (AOI) formed by the aspiration catheter and the clot is related to DTA efficacy. The aims of this study were three-fold: (a) to confirm the clinical finding that the AOI formed by the aspiration catheter and the clot influence DTA efficacy; (b) to evaluate to what extent this influence varies according to differences in clot consistency and size; and (c) to validate stent retriever thrombectomy as an effective rescue treatment after DTA failure in the presence of an unfavorable AOI.

METHODS

A rigid vascular phantom designed to reproduce a middle cerebral artery trifurcation anatomy with three M2 segments forming different angles with M1 and thrombus analog of different consistencies and sizes was used.

RESULTS

DTA was highly effective for AOIs >125.5°, irrespective of thrombus analog features. However, its efficacy decreased for acute AOIs. Rescue stent retriever thrombectomy was effective in 92.6% of cases of DTA failure.

CONCLUSIONS

This in vitro study confirmed that the AOI formed by the aspiration catheter and the thrombus analog influenced DTA efficacy, with an AOI >125.5° related to an effective DTA. Stent retriever thrombectomy was an effective rescue treatment after DTA failure, even in the presence of an unfavorable AOI.

Abstract

BACKGROUND

Successful direct thromboaspiration (DTA) is related to several factors such as clot consistency, size, and location. It has also been demonstrated recently that the angle of interaction (AOI) formed by the aspiration catheter and the clot is related to DTA efficacy. The aims of this study were three-fold: (a) to confirm the clinical finding that the AOI formed by the aspiration catheter and the clot influence DTA efficacy; (b) to evaluate to what extent this influence varies according to differences in clot consistency and size; and (c) to validate stent retriever thrombectomy as an effective rescue treatment after DTA failure in the presence of an unfavorable AOI.

METHODS

A rigid vascular phantom designed to reproduce a middle cerebral artery trifurcation anatomy with three M2 segments forming different angles with M1 and thrombus analog of different consistencies and sizes was used.

RESULTS

DTA was highly effective for AOIs >125.5°, irrespective of thrombus analog features. However, its efficacy decreased for acute AOIs. Rescue stent retriever thrombectomy was effective in 92.6% of cases of DTA failure.

CONCLUSIONS

This in vitro study confirmed that the AOI formed by the aspiration catheter and the thrombus analog influenced DTA efficacy, with an AOI >125.5° related to an effective DTA. Stent retriever thrombectomy was an effective rescue treatment after DTA failure, even in the presence of an unfavorable AOI.

Statistics

Citations

Dimensions.ai Metrics

Altmetrics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Neuroradiology
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Surgery
Health Sciences > Neurology (clinical)
Language:English
Date:22 January 2021
Deposited On:04 Feb 2021 07:26
Last Modified:05 Feb 2021 21:05
Publisher:BMJ Publishing Group
ISSN:1759-8478
OA Status:Closed
Publisher DOI:https://doi.org/10.1136/neurintsurg-2020-016889
PubMed ID:33483456

Download

Full text not available from this repository.
View at publisher

Get full-text in a library