Safety and Effectiveness of Neuro-thrombectomy on Single compared to Biplane Angiography Systems.

Guenego, Adrien; Mosimann, Pascal J.; Wintermark, Max; Heit, Jeremy J; Zuber, Kevin; Dobrocky, Tomas; Lotterie, Jean Albert; Nicholson, Patrick; Marcellus, David G; Olivot, Jean Marc; Gonzalez, Nestor; Blanc, Raphaël; Pereira, Vitor Mendes; Gralla, Jan; Kaesmacher, Johannes; Fahed, Robert; Piotin, Michel; Cognard, Christophe (2020). Safety and Effectiveness of Neuro-thrombectomy on Single compared to Biplane Angiography Systems. Scientific Reports, 10(1), p. 4470. Nature Publishing Group 10.1038/s41598-020-60851-4

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An increasing number of centers not necessarily equipped with biplane (BP) angiosuites are performing mechanical thrombectomy (MT) in acute ischemic stroke patients. We assessed whether MT performed on single-plane (SP) is equivalent in terms of safety, effectiveness, radiation and contrast agent exposure. Consecutive patients treated by MT in four high volume centers between January 2014 and May 2017 were included. Demographic and MT characteristics were assessed and compared between SP and BP. Of 906 patients treated by MT, 576 (64%) were handled on a BP system. After multivariate analysis, contrast load and fluoroscopy duration were significantly lower in the BP group [100vs200mL, relative effect 0.85 (CI: 0.79-0.92), p = 0.0002; 22 vs 27 min, relative effect 0.84 (CI: 0.76-0.93), p = 0.0008, respectively]. There was no difference in recanalization (modified Thrombolysis-In-Cerebral-Infarction 2b-3), good clinical outcome (modified Rankin Scale 0-2), complications rates, procedure duration or radiation exposure. A three-vessel diagnostic angiogram performed prior to MT led to a significant increase in procedure duration (15% increase, p = 0.05), radiation exposure (33% increase, p < 0.0001) and contrast load (125% increase, p < 0.0001). Mechanical neuro-thrombectomy seems equally safe and effective on a single or biplane angiography system despite increased contrast load and fluoroscopy duration on the former.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

UniBE Contributor:

Mosimann, Pascal John; Dobrocky, Tomas; Gralla, Jan and Kaesmacher, Johannes

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2045-2322

Publisher:

Nature Publishing Group

Language:

English

Submitter:

Martin Zbinden

Date Deposited:

07 Apr 2020 15:35

Last Modified:

12 Apr 2020 02:50

Publisher DOI:

10.1038/s41598-020-60851-4

PubMed ID:

32161286

BORIS DOI:

10.7892/boris.142010

URI:

https://boris.unibe.ch/id/eprint/142010

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