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Journal of Neuroimaging - 2025 - Puig - Distal Access Catheter Improves Balloon Guide and Stent Retriever Thrombectomy.pdf (206.92 KB)

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2025-01-01

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cc-by-nc (c) Puig, Josep et al., 2025
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/219393

Distal Access Catheter Improves Balloon Guide and Stent Retriever Thrombectomy Outcomes in Nonagenarians

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Recurs relacionat

https://doi.org/10.1111/jon.70012

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Background and PurposeThe safety and effectiveness of endovascular techniques in elderly patients with large vessel occlusion (LVO) remain controversial. We investigated the angiographic and clinical outcomes of nonagenarians treated with different endovascular techniques using a balloon guide catheter (BGC), distal aspiration catheter (DAC), and/or stent retriever (SR).MethodsWe analyzed the data from the Registry of Combined versus Single Thrombectomy Techniques (ROSSETTI) of consecutive nonagenarian patients with anterior circulation LVO and compared the outcomes of those treated with BGC+noDAC+SR (101-group), BGC+DAC+SR (111-group), and noBGC+DAC+SR (011-group). Demographic, clinical, angiographic, and clinical outcome data (National Institute of Health Stroke Scale score at 24 h [24h-NIHSS] and modified Rankin Scale score at 3 months) were compared. Predictors of the first-pass effect (FPE), defining Modified Treatment In Cerebral Ischemia 2c-3 (mTICI 2c-3) after one pass, were explored.ResultsOf the 4111 patients from the ROSSETTI registry, 243 nonagenarians (68.7% female) were included in the analysis. The distribution of endovascular techniques was 101-group (61.4%), 111-group (15.6%), and 011-group (23%). The 101-group and 111-group had significantly shorter procedural times than the 011-group. The 111-group had a higher FPE rate, a lower number of passes, and a higher rate of final mTICI >= 2c than the other groups. The 24h-NIHSS score was significantly lower in the 111-group. In multivariate analysis, the only independent predictor for FPE was the BGC+DAC+SR endovascular technique (odds ratio 2.74 [confidence interval 1.16-6.47]; p = 0.021).ConclusionsThe addition of a DAC to a BGC increases the likelihood of FPE in nonagenarians with anterior circulation LVO SR-based thrombectomy for acute stroke.

Matèries

Persones grans, Oclusions arterials, Cirurgia vascular

Matèries (anglès)

Older people, Arterial occlusions, Vascular surgery

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Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

Citació

PUIG, Josep, WERNER, Mariano, DOLZ ALVAREZ DE LA BALLINA, Guillem, PASCAGAZA, Alejandro, DAUNIS I ESTADELLA, Pepus, COMAS CUFÍ, Marc, GONZÁLEZ, Eva, FONDEVILA, Jon, VEGA, Pedro, MURIAS, Eduardo, ROMERO, Veredas, MARTÍNEZ, Carlos, APARICI ROBLES, Fernando, MORALES CABA, Lluis, REMOLLO, Sebastià, RODRÍGUEZ CAAMAÑO, Isabel, PÉREZ GARCÍA, Carlos, ROSATI, Santiago, BASHIR, Saima, VIELBA GOMEZ, Isabel, AIXUT, Sonia, PAIPA, Andrés julian, MARTÍNEZ FERNÁNDEZ, Javier, AGUILAR, Yeray, FANDIÑO, Eduardo, BARBIERI, Giorgio, GARCÍA VILLALBA, Blanca, CUBA, Víctor, CASTAÑO, Miguel, BLASCO, Jordi, Rossetti Group. Distal Access Catheter Improves Balloon Guide and Stent Retriever Thrombectomy Outcomes in Nonagenarians. _Journal of Neuroimaging_. 2025. Vol. 35, núm. 1. [consulta: 8 de febrer de 2026]. ISSN: 1552-6569. [Disponible a: https://hdl.handle.net/2445/219393]

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