Abstract W MP4: Stentriever Mediated Manual Aspiration Thrombectomy (SMAT) for Acute Ischemic Stroke in 93 Consecutive Patients
Background and Purpose: Both stentriever technology and manual aspiration thrombectomy have been demonstrated to independently lead to high rates of recanalization in acute ischemic strokes presenting with large vessel occlusions. We sought to describe the safety and efficacy of a multimodal approach combining the two techniques.
Methods: Retrospective review of a prospectively acquired acute endovascular stroke database.
Results: 93 consecutive patients were identified presenting between July 2013 and July 2014. Median age: 67. Median NIHSS: 17. Patients had the following baseline features: 48% female gender, 72% hypertension, 12% diabetes, 39% atrial fibrillation, 29% CAD. Occlusion distribution included 71% M1, 13% M2, 13% ICAT, 16% VB. On presentation, 28% received IV tpa and 34% presented beyond 8 hours. High quality recanalization (TICI2b/3) was achieved in 88% of patients. Recanalization required an average of 2.36 passes. The Solitaire stentriever was used in 81% of cases and the Trevo device was used in the remainder of cases. The aspiration catheter employed was the 072/058 Navien in 74% of cases, 043 DAC in 4% of cases and 5Max ACE in 27% of cases. Median door to groin puncture time was 69 minutes and median groin puncture to recanalization time was 47 minutes. Symptomatic hemorrhage occurred in 5% of patients. Good outcomes were noted in 42% of patients. In anterior circulation stroke patients who received IV tpa prior to IA therapy, good outcomes were noted in 50% of patients.
Conclusions: SMAT is a safe and efficacious method of achieving rapid revascularization in acute stroke patients. Future prospective comparisons of MAT, stentreiver alone and SMAT are necessary to establish the most clinical effective therapy for acute thrombectomy.
Author Disclosures: A.P. Jadhav: None. N. Aghaebrahim: None. A. Horev: None. D. Giurgiutiu: None. A. Ducruet: None. B. Jankowitz: None. T. Jovin: None.
- © 2015 by American Heart Association, Inc.