Aldo Paolucci (Italy)
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy Unit of NeuroradiologyAuthor Of 1 Presentation
COMPARISON OF ASPIRATION VERSUS COMBINED TECHNIQUE AS FIRST LINE APPROACH IN TERMINAL INTERNAL CAROTID ARTERY OCCLUSION: A MULTICENTER EXPERIENCE.
Abstract
Background and Aims
There is not consensus about the most effective endovascular technique to be used in patients with acute ischemic stroke due to terminal internal carotid artery (ICA) occlusion. The aim of this study was to compare safety and efficacy of aspiration technique (AT) and combined technique (CT) as first line approach in terminal ICA occlusions.
Methods
We performed a retrospective analysis of prospectively collected databases of seven Italian stroke centers. Patients were divided in two subgroups, according to the first line approach: aspiration technique group or combined technique group. We followed the STROBE guidelines for cohort studies. We used the Chi2 test, the One Way and Multivariate ANOVA analysis along with Contrast analysis and Post-Hoc Tests, the logistic regression and the Pearson’s Bivariate correlation for the statistical analysis
Results
Between January 2018 and August 2020, 353 patients were treated for a terminal ICA occlusion, with AT or CT. CT was associated with a higher TICI 2B-3 after the first pass (51.0% vs. 26.9%) and at the end of the procedure (84% vs. 73.3%), and with higher good clinical outcome at the discharge (mRs 0-2 of 47.8% vs. 34%) and at 3 months follow-up (mRs 0-2 of 56.5% vs. 38.9%) compared with the AT.
Conclusions
Thrombectomy of terminal ICA occlusions obtained by using the CT as first line approach demonstrated better technical and functional outcomes in comparison with the AT.