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Increased Number of Passes and Double Stent Retriever Technique Induces Cumulative Injury on Arterial Wall After Mechanical Thrombectomy in a Swine Model.
Hernández, David; Cuevas, José Luis; Gramegna, Laura Ludovica; Requena, Manuel; Piñana, Carlos; de Dios, Marta; Coscojuela, Pilar; Esteves, Marielle; Li, Jiahui; Gil, Alberto; Ribó, Marc; Tomasello, Alejandro.
Afiliación
  • Hernández D; Interventional Neuroradiology Section, Vall d'Hebron University Hospital, Pg Vall d'Hebron 119-129, 08035, Barcelona, Spain.
  • Cuevas JL; Neurosurgery and Interventional Neuroradiology, Hospital de Puerto Montt, Puerto Montt, Chile.
  • Gramegna LL; Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain.
  • Requena M; Department of Biomedical and Motor Sciences, University of Bologna, Bologna, Italy.
  • Piñana C; IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Bologna, Italy.
  • de Dios M; Interventional Neuroradiology Section, Vall d'Hebron University Hospital, Pg Vall d'Hebron 119-129, 08035, Barcelona, Spain.
  • Coscojuela P; Stroke Unit, Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
  • Esteves M; Interventional Neuroradiology Section, Vall d'Hebron University Hospital, Pg Vall d'Hebron 119-129, 08035, Barcelona, Spain.
  • Li J; Interventional Neuroradiology Section, Vall d'Hebron University Hospital, Pg Vall d'Hebron 119-129, 08035, Barcelona, Spain.
  • Gil A; Interventional Neuroradiology Section, Vall d'Hebron University Hospital, Pg Vall d'Hebron 119-129, 08035, Barcelona, Spain.
  • Ribó M; Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain.
  • Tomasello A; Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain.
Transl Stroke Res ; 14(3): 425-433, 2023 06.
Article en En | MEDLINE | ID: mdl-35672562
The number of stentriever passes during endovascular thrombectomy impacts clinical outcomes in acute ischemic stroke. Previous studies suggest that the simultaneous double stent retriever technique (DSRT) could improve the efficacy and reduce the number of passes. We aim to analyze the degree of vessel wall injury according to the number of passes and technique (single vs. simultaneous devices). Histological changes were evaluated in renal arteries (RAs) of swine models after thrombectomy (1, 2, or 3 passes) with single stent (SSRT) and DSRT. Thrombectomy passes were performed in 12 RA: 3 samples from each artery were studied by optical microscopy to assess a vascular damage score. All thirty-six samples showed endothelial denudation and different degrees of damage in the deepest layers of the arterial wall; however, all arteries remained patent by the time of assessment. In all cases, the degree of vascular injury increased with the number of passes. Compared with a SSRT, DSRT showed a higher severity of histological damage corresponding to the damage caused by 1.4 SSRT passes. However, in distal arteries, vascular damage was relatively similar when comparing SSRT with multiple passes and DSRT with one pass. The degree of vessel injury increases with the number of passes. Even though histological damage per pass was 1.4 higher with DSRT than SSRT, short-term vessel patency was not compromised after up to 3 DSRT passes. Further studies are needed to characterize the risk-benefit ratio of the DSRT in routine clinical practice.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Accidente Cerebrovascular / Accidente Cerebrovascular Isquémico Tipo de estudio: Prognostic_studies Límite: Animals Idioma: En Revista: Transl Stroke Res Año: 2023 Tipo del documento: Article País de afiliación: España Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Accidente Cerebrovascular / Accidente Cerebrovascular Isquémico Tipo de estudio: Prognostic_studies Límite: Animals Idioma: En Revista: Transl Stroke Res Año: 2023 Tipo del documento: Article País de afiliación: España Pais de publicación: Estados Unidos