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    Super large-bore ingestion of clot (SLIC) leads to high first pass effect in thrombectomy for large vessel occlusion

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    Authors
    Massari, Francesco
    Dabus, Guilherme
    Cortez, Gustavo M.
    Singh, Jasmeet
    Kuhn, Anna L.
    Naragum, Varun
    Anagnostakou, Vania
    Hanel, Ricardo A.
    Gounis, Matthew J.
    Puri, Ajit S.
    UMass Chan Affiliations
    New England Center for Stroke Research
    Division of Neurointerventional Radiology, University of Massachusetts Medical Center
    Department of Radiology
    Document Type
    Journal Article
    Publication Date
    2022-06-22
    Keywords
    Catheter
    Intervention
    Stroke
    Technique
    Cardiovascular Diseases
    Nervous System Diseases
    Neurology
    Neurosurgery
    Radiology
    
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    Link to Full Text
    https://doi.org/10.1136/neurintsurg-2022-018806
    Abstract
    BACKGROUND: Super large-bore aspiration (SLBA) has shown high rates of complete clot ingestion. OBJECTIVE: To report the initial clinical feasibility, safety, and efficacy of this novel SLBA insert combination-super large-bore ingestion of clot (SLIC) technique for stroke. METHODS: We performed a retrospective review of three comprehensive stroke center databases. The SLIC technique entails a triaxial assembly of an 8 Fr 0.106'' Base Camp catheter, 0.088'' catheter extender (HiPoint), and an insert catheter (Tenzing 8) that completely consumes the inner diameter of the 0.088'' SLBA catheter. The HiPoint catheter is delivered over the Tenzing 8 to the face of the embolus, which is withdrawn, while aspirating through the Base Camp and HiPoint catheters as a single assembly. RESULTS: Thirty-three consecutive patients with large vessel occlusion were treated with SLIC. The median age was 70 years (30-91) and 17 were male (51.5%). The median presenting National Institutes of Health Stroke Scale score and Alberta Stroke Program Early CT score was 21 (1-34) and 8 (5-10), respectively. There was 100% success in delivering the 0.088'' catheter to the site of the occlusion. The successful revascularization rate (modified Thrombolysis in Cerebral Infarction (mTICI) score > /=2B) was 100% within a single pass in most cases (82%). Final mTICI > /=2C was achieved in 94.1% of occlusions, with 73.5% mTICI 3 recanalization. The rate of first pass effect in achieving excellent reperfusion (mTICI > /=2C) was 70.5%. There were no adverse events or postprocedural symptomatic hemorrhages. CONCLUSIONS: Our initial experience with the SLIC technique resulted in achieving a first pass effect (mTICI > /=2C) in 70.5%. Navigation of the SLBA catheter extender over the Tenzing insert was successful and safe in this early experience.
    Source

    Massari F, Dabus G, Cortez GM, Singh J, Kuhn AL, Naragum V, Anagnostakou V, Hanel RA, Gounis MJ, Puri AS. Super large-bore ingestion of clot (SLIC) leads to high first pass effect in thrombectomy for large vessel occlusion. J Neurointerv Surg. 2022 Jun 22:neurintsurg-2022-018806. doi: 10.1136/neurintsurg-2022-018806. Epub ahead of print. PMID: 35732483. Link to article on publisher's site

    DOI
    10.1136/neurintsurg-2022-018806
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/48643
    PubMed ID
    35732483
    Related Resources

    Link to Article in PubMed

    ae974a485f413a2113503eed53cd6c53
    10.1136/neurintsurg-2022-018806
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