Document Detail


Recanalization rates decrease with increasing thrombectomy attempts.
MedLine Citation:
PMID:  20075091     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Use of the Merci retriever is increasing as a means to reopen large intracranial arterial occlusions. We sought to determine whether there is an optimum number of retrieval attempts that yields the highest recanalization rates and after which the probability of success decreases. MATERIALS AND METHODS: All consecutive patients undergoing Merci retrieval for large cerebral artery occlusions were prospectively tracked at a comprehensive stroke center. We analyzed ICA, M1 segment of the MCA, and vertebrobasilar occlusions. We compared the revascularization of the primary AOL with the number of documented retrieval attempts used to achieve that AOL score. For tandem lesions, each target lesion was compared separately on the basis of where the device was deployed. RESULTS: We identified a total of 97 patients with 115 arterial occlusions. The median number of attempts per target vessel was 3, while the median final AOL score was 2. Up to 3 retrieval attempts correlated with good revascularization (AOL 2 or 3). When >or=4 attempts were performed, the end result was more often failed revascularization (AOL 0 or 1) and procedural complications (P = .006). CONCLUSIONS: In our experience, 3 may be the optimum number of Merci retrieval attempts per target vessel occlusion. Four or more attempts may not improve the chances of recanalization, while increasing the risk of complications.
Authors:
Y Loh; R Jahan; D L McArthur; Z-S Shi; N R Gonzalez; G R Duckwiler; P M Vespa; S Starkman; J L Saver; S Tateshima; D S Liebeskind; F Viñuela
Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2010-01-14
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  31     ISSN:  1936-959X     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-17     Completed Date:  2010-09-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  935-9     Citation Subset:  IM    
Affiliation:
Division of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA. yincer@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
California / epidemiology
Cerebral Arterial Diseases / epidemiology*,  radiography,  surgery*
Female
Humans
Male
Middle Aged
Prognosis
Reoperation / statistics & numerical data
Thrombectomy / instrumentation*,  statistics & numerical data*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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