ARTS (Aspiration-Retriever Technique for Stroke): Initial clinical experience
Department of Radiology; Department of Neurology
Nervous System Diseases | Neurology | Radiology
BACKGROUND: A new generation of highly navigable large-bore aspiration catheters and retriever devices for intracranial mechanical thrombectomy has markedly improved recanalization rates, time and clinical outcomes. We report collected clinical data utilizing a new technique based on combined large lumen aspiration catheter and partially resheathed stent retriever (ARTS: Aspiration (catheter)-(stent) Retriever Technique for Stroke). This technique is applied, especially in presence of bulky/rubbery emboli, when resistance is felt while retracting the stent retriever; at that point the entire assembly is locked and removed in-toto under continuous aspiration with additional flow arrest.
METHODS: A retrospective data analysis was performed to identify patients with large cerebral artery acute ischemic stroke treated with ARTS. The study was conducted between August 2013 and February 2015 at a single high volume stroke center. Procedural and clinical data were captured for analysis.
RESULTS: Forty-two patients (median age 66 years) met inclusion criteria for this study. The ARTS was successful in achieving Thrombolysis in Cerebral Infarction (TICI) > /=2b revascularization in 97.6% of cases (TICI 2b = 18 patients, TICI 3 = 23 patients). Patients' median National Institutes of Health Stroke Scale score at admission was 18 (6-40). A 3-month follow-up modified Rankin Scale value of 0-2 was achieved in 65.7% of the successfully treated patients (average 2.4). Two patients (4.8%) developed symptomatic intraparenchymal hemorrhages. Six procedure unrelated deaths were observed.
CONCLUSIONS: We found that ARTS is a fast, safe and effective method for endovascular recanalization of large vessel occlusions presenting within the context of acute ischemic stroke.
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Citation: Interv Neuroradiol. 2016 Jun;22(3):325-32. doi: 10.1177/1591019916632369. Epub 2016 Feb 22. Link to article on publisher's site
Stroke, TICI, aspiration catheter, mechanical thrombectomy, stent retriever
Massari, Francesco; Henninger, Nils; Lozano, Juan Diego; Patel, Anand; Kuhn, Anna L.; Howk, Mary; Perras, Mary; Brooks, Christopher; Gounis, Matthew J.; Kan, Peter; Wakhloo, Ajay K.; and Puri, Ajit S., "ARTS (Aspiration-Retriever Technique for Stroke): Initial clinical experience" (2016). Neurology Publications and Presentations. 426.