eScholarship@UMMS

Title

ARTS (Aspiration-Retriever Technique for Stroke): Initial clinical experience

Authors

Francesco Massari, University of Massachusetts Medical SchoolFollow
Nils Henninger, University of Massachusetts Medical SchoolFollow
Juan Diego Lozano, University of Massachusetts Medical SchoolFollow
Anand Patel, University of Massachusetts Medical SchoolFollow
Anna L. Kuhn, University of Massachusetts Medical SchoolFollow
Mary Howk, University of Massachusetts Medical SchoolFollow
Mary Perras, University of Massachusetts Medical SchoolFollow
Christopher Brooks, University of Massachusetts Medical SchoolFollow
Matthew J. Gounis, University of Massachusetts Medical SchoolFollow
Peter Kan, Baylor College of Medicine
Ajay K. Wakhloo, University of Massachusetts Medical SchoolFollow
Ajit S. Puri, University of Massachusetts Medical SchoolFollow

UMMS Affiliation

Department of Radiology; Department of Neurology

Publication Date

2016-06-01

Document Type

Article

Disciplines

Nervous System Diseases | Neurology | Radiology

Abstract

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.

Keywords

Stroke, TICI, aspiration catheter, mechanical thrombectomy, stent retriever

DOI of Published Version

10.1177/1591019916632369

Source

Interv Neuroradiol. 2016 Jun;22(3):325-32. doi: 10.1177/1591019916632369. Epub 2016 Feb 22. Link to article on publisher's site

Journal/Book/Conference Title

Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences

Comments

Co-author Nils Henninger is a doctoral student in the Millennium PhD Program (MPP) in the Graduate School of Biomedical Sciences (GSBS) at UMass Medical School.

Related Resources

Link to Article in PubMed

PubMed ID

26908591

Repository Citation

Massari F, Henninger N, Lozano JD, Patel A, Kuhn AL, Howk M, Perras M, Brooks C, Gounis MJ, Kan P, Wakhloo AK, Puri AS. (2016). ARTS (Aspiration-Retriever Technique for Stroke): Initial clinical experience. Neurology Publications. https://doi.org/10.1177/1591019916632369. Retrieved from https://escholarship.umassmed.edu/neuro_pp/426