1. Safety and Effectiveness of Neuro-thrombectomy on Single compared to Biplane Angiography Systems
- Author
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Max Wintermark, Nestor R Gonzalez, Pascal J. Mosimann, Christophe Cognard, Vitor Mendes Pereira, Jean Albert Lotterie, Kevin Zuber, Raphaël Blanc, Robert Fahed, Adrien Guenego, Johannes Kaesmacher, Radon Investigators, Jean-Marc Olivot, Patrick Nicholson, Jan Gralla, Michel Piotin, Jeremy J Heit, David G. Marcellus, and Tomas Dobrocky
- Subjects
Adult ,Male ,Mechanical Thrombolysis ,Biplane angiography ,lcsh:Medicine ,610 Medicine & health ,030204 cardiovascular system & hematology ,Article ,Diagnostic angiogram ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Modified Rankin Scale ,Risk Factors ,Medicine ,Humans ,lcsh:Science ,Acute ischemic stroke ,Aged ,Thrombectomy ,Aged, 80 and over ,Public health ,Multidisciplinary ,business.industry ,lcsh:R ,Angiography ,Middle Aged ,Health policy ,Mechanical thrombectomy ,Radiation exposure ,Stroke ,Treatment Outcome ,Procedure Duration ,lcsh:Q ,Female ,business ,Nuclear medicine ,030217 neurology & neurosurgery ,Neurological disorders ,Fluoroscopy duration - Abstract
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 27 min, 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
- Published
- 2019
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