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Possible Contribution of the Aspiration Catheter in Preventing Post-stent Retriever Thrombectomy Subarachnoid Hemorrhage.
Nariai, Yasuhiko; Takigawa, Tomoji; Kawamura, Yosuke; Hyodo, Akio; Suzuki, Kensuke.
Afiliación
  • Nariai Y; Department of Neurosurgery, Kamagaya General Hospital, 929-6 Hatsutomi, 273-0121, Kamagaya-shi, Chiba, Japan. nariainari@gmail.com.
  • Takigawa T; Department of Neurosurgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan.
  • Kawamura Y; Department of Neurosurgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan.
  • Hyodo A; Department of Neurosurgery, Kamagaya General Hospital, 929-6 Hatsutomi, 273-0121, Kamagaya-shi, Chiba, Japan.
  • Suzuki K; Department of Neurosurgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan.
Clin Neuroradiol ; 33(2): 509-518, 2023 Jun.
Article en En | MEDLINE | ID: mdl-36550356
PURPOSE: This study aimed to identify factors related to the incidence of post-thrombectomy subarachnoid hemorrhage (PTSAH). METHODS: This retrospective, observational cohort study enrolled consecutive patients with acute ischemic stroke (AIS) due to the internal carotid artery (IC) top or middle cerebral artery (MCA) M1 or M2 segment occlusion who underwent single-pass stent retriever (SR) treatment between January 2015 and May 2022 at two acute care hospitals. RESULTS: Of the 54 included patients, 10 were in the PTSAH group (18.5%). The occlusion sites were IC top (31.5%), M1 segment (48.1%), and M2 segment (20.4%). Aspiration catheters (ACs) were used in 32 (59.3%) patients; however, the combined technique (AC advancement at least to the most proximal marker of SR) was actually used in 26 (48.1%) patients because a ledge effect at the ophthalmic artery origin from the IC interfered with distal navigation of the ACs. The baseline patient characteristics did not differ between the groups. M2 segment occlusion in the PTSAH and non-PTSAH groups were 40.0% and 15.9%, respectively (p = 0.19). More ACs were used in the non-PTSAH group (65.9% vs. 30.0%, p = 0.07). Significantly fewer combined techniques were performed in the PTSAH group (10.0% vs. 56.8%, p = 0.01). In multivariate analysis adjusted by variables with M2 segment occlusion and the combined technique, the combined technique (odds ratio 0.098; 95% confidence interval, 0.011-0.887; p = 0.039) was identified as a significantly associated factor for PTSAH. There was one PTSAH case (1.9%) with symptom worsening. CONCLUSION: The combined technique significantly influenced PTSAH occurrence as a preventive factor.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hemorragia Subaracnoidea / Isquemia Encefálica / Accidente Cerebrovascular / Procedimientos Endovasculares / Accidente Cerebrovascular Isquémico Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Clin Neuroradiol Asunto de la revista: NEUROLOGIA / RADIOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hemorragia Subaracnoidea / Isquemia Encefálica / Accidente Cerebrovascular / Procedimientos Endovasculares / Accidente Cerebrovascular Isquémico Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Clin Neuroradiol Asunto de la revista: NEUROLOGIA / RADIOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Alemania