Safety and Effectiveness of Neuro-thrombectomy on Single compared to Biplane Angiography Systems

被引:14
作者
Guenego, Adrien [1 ]
Mosimann, Pascal J. [2 ]
Wintermark, Max [3 ]
Heit, Jeremy J. [3 ]
Zuber, Kevin [4 ]
Dobrocky, Tomas [2 ]
Lotterie, Jean Albert [5 ]
Nicholson, Patrick [6 ]
Marcellus, David G. [3 ]
Olivot, Jean Marc [7 ]
Gonzalez, Nestor [8 ]
Blanc, Raphael [9 ]
Pereira, Vitor Mendes [6 ]
Gralla, Jan [2 ]
Kaesmacher, Johannes [2 ]
Fahed, Robert [9 ]
Piotin, Michel [9 ]
Cognard, Christophe [1 ]
机构
[1] Toulouse Univ Hosp, Intervent & Diagnost Neuroradiol Dept, Toulouse, France
[2] Intervent & Diagnost Neuroradiol, Bern, Switzerland
[3] Stanford Med Ctr, Intervent & Diagnost Neuroradiol, Stanford, CA USA
[4] Fdn Ophtalmol Adolphe de Rothschild, Stat Dept, Paris, France
[5] Toulouse Univ Hosp, Stereotax Neurosurg Dept, Toulouse, France
[6] Toronto Hosp, Intervent & Diagnost Neuroradiol, Toronto, ON, Canada
[7] Toulouse Univ Hosp, Stroke Dept, Vasc Neurol, Toulouse, France
[8] Cedars Sinai Med Ctr, Neurosurg & Intervent Neuroradiol Dept, Los Angeles, CA USA
[9] Fdn Ophtalmol Adolphe de Rothschild, Intervent Neuroradiol, Paris, France
关键词
ACUTE ISCHEMIC-STROKE; HEALTH-CARE PROFESSIONALS; ENDOVASCULAR THROMBECTOMY; MECHANICAL THROMBECTOMY; EARLY MANAGEMENT; STENT-RETRIEVER; INTERVENTIONS; GUIDELINES; NEPHROPATHY; STANDARDS;
D O I
10.1038/s41598-020-60851-4
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
An increasing number of centers not necessarily equipped with biplane (BP) angiosuites are performing mechanical thrombectomy (MT) in acute ischemic stroke patients. We assessed whether MT performed on single-plane (SP) is equivalent in terms of safety, effectiveness, radiation and contrast agent exposure. Consecutive patients treated by MT in four high volume centers between January 2014 and May 2017 were included. Demographic and MT characteristics were assessed and compared between SP and BP. Of 906 patients treated by MT, 576 (64%) were handled on a BP system. After multivariate analysis, contrast load and fluoroscopy duration were significantly lower in the BP group [100vs200mL, relative effect 0.85 (CI: 0.79-0.92), p=0.0002; 22 vs 27min, relative effect 0.84 (CI: 0.76-0.93), p=0.0008, respectively]. There was no difference in recanalization (modified Thrombolysis-In-Cerebral-Infarction 2b-3), good clinical outcome (modified Rankin Scale 0-2), complications rates, procedure duration or radiation exposure. A three-vessel diagnostic angiogram performed prior to MT led to a significant increase in procedure duration (15% increase, p=0.05), radiation exposure (33% increase, p<0.0001) and contrast load (125% increase, p<0.0001). Mechanical neuro-thrombectomy seems equally safe and effective on a single or biplane angiography system despite increased contrast load and fluoroscopy duration on the former.
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页数:8
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