The New Fully Radiopaque Aperio Hybrid Stent Retriever: Efficient and Safe? An Early Multicenter Experience

To investigate the visibility, safety, and efficacy of the full-length radiopaque Aperio Hybrid stent retriever (APH) in mechanical thrombectomy of large vessel occlusions. Multicentric retrospective analysis of patients with stroke, treated with the APH due to an acute ischemic stroke by large vess...

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Veröffentlicht in:	World neurosurgery 2020-09, Vol.141, p.e278-e288
Hauptverfasser:	Kaschner, Marius, Lichtenstein, Thorsten, Weiss, Daniel, Turowski, Bernd, Goertz, Lukas, Kluner, Claudia, Schlamann, Marc, Mathys, Christian, Kabbasch, Christoph
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Schlagworte:	Aged Aperio Hybrid Clinical Neurology Endovascular Procedures - instrumentation Female Humans Ischemic stroke Life Sciences & Biomedicine Male Mechanical thrombectomy Middle Aged Neurosciences & Neurology Recanalization Retrospective Studies Science & Technology Stent retriever Stroke - surgery Surgery Thrombectomy - instrumentation
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description	To investigate the visibility, safety, and efficacy of the full-length radiopaque Aperio Hybrid stent retriever (APH) in mechanical thrombectomy of large vessel occlusions. Multicentric retrospective analysis of patients with stroke, treated with the APH due to an acute ischemic stroke by large vessel occlusions in the anterior or posterior circulation, was performed. We focused on technical and angiographic parameters including device visibility, perfusion results (modified thrombolysis in cerebral infarction scale [mTICI]), procedural times, periprocedural complications, and favorable clinical outcome (modified Rankin Scale, 0–2) at discharge and after 90 days. A total of 48 patients (male: n = 22, 45.8%, mean age 73 years [standard deviation (SD), ±15], median baseline National Institutes of Health Stroke Scale: 15 [2–36], n = 25, 52.1% received additional intravenous thrombolytics) were treated with the APH with a mean number of 2 device passes (SD, +3) in APH-only cases (n = 41). The median time from groin puncture to the final mTICI was 54 minutes (SD, +33). In 46 patients (95.8%), mTICI 2b–3 was achieved (mTICI 2c, 12.5%; mTICI 3, 47.9%). Favorable outcome (modified Rankin Scale
doi_str_mv	10.1016/j.wneu.2020.05.104
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Multicentric retrospective analysis of patients with stroke, treated with the APH due to an acute ischemic stroke by large vessel occlusions in the anterior or posterior circulation, was performed. We focused on technical and angiographic parameters including device visibility, perfusion results (modified thrombolysis in cerebral infarction scale [mTICI]), procedural times, periprocedural complications, and favorable clinical outcome (modified Rankin Scale, 0–2) at discharge and after 90 days. A total of 48 patients (male: n = 22, 45.8%, mean age 73 years [standard deviation (SD), ±15], median baseline National Institutes of Health Stroke Scale: 15 [2–36], n = 25, 52.1% received additional intravenous thrombolytics) were treated with the APH with a mean number of 2 device passes (SD, +3) in APH-only cases (n = 41). The median time from groin puncture to the final mTICI was 54 minutes (SD, +33). In 46 patients (95.8%), mTICI 2b–3 was achieved (mTICI 2c, 12.5%; mTICI 3, 47.9%). Favorable outcome (modified Rankin Scale <2) was achieved in 15 (32.6%) patients at discharge and in 11 of the 30 (36.7%) patients available for 90-day follow-up. Symptomatic intracranial hemorrhage was recorded in 3 of 48 cases (6.3%). Difficulties during device delivery and/or deployment occurred in 6.3% (3 of 48). APH-related adverse events did not occur. APH radiopacity was rated as good and very good in 97.9% (47 of 48). Mechanical thrombectomy with the APH appeared feasible, efficient, and safe. Full-length device radiopacity may facilitate thrombectomy or support to adapt the course of action during retrieval, if required.</description><identifier>ISSN: 1878-8750</identifier><identifier>EISSN: 1878-8769</identifier><identifier>DOI: 10.1016/j.wneu.2020.05.104</identifier><identifier>PMID: 32434034</identifier><language>eng</language><publisher>NEW YORK: Elsevier Inc</publisher><subject>Aged ; Aperio Hybrid ; Clinical Neurology ; Endovascular Procedures - instrumentation ; Female ; Humans ; Ischemic stroke ; Life Sciences & Biomedicine ; Male ; Mechanical thrombectomy ; Middle Aged ; Neurosciences & Neurology ; Recanalization ; Retrospective Studies ; Science & Technology ; Stent retriever ; Stroke - surgery ; Surgery ; Thrombectomy - instrumentation</subject><ispartof>World neurosurgery, 2020-09, Vol.141, p.e278-e288</ispartof><rights>2020 Elsevier Inc.</rights><rights>Copyright © 2020 Elsevier Inc. 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An Early Multicenter Experience</title><title>World neurosurgery</title><addtitle>WORLD NEUROSURG</addtitle><addtitle>World Neurosurg</addtitle><description>To investigate the visibility, safety, and efficacy of the full-length radiopaque Aperio Hybrid stent retriever (APH) in mechanical thrombectomy of large vessel occlusions. Multicentric retrospective analysis of patients with stroke, treated with the APH due to an acute ischemic stroke by large vessel occlusions in the anterior or posterior circulation, was performed. We focused on technical and angiographic parameters including device visibility, perfusion results (modified thrombolysis in cerebral infarction scale [mTICI]), procedural times, periprocedural complications, and favorable clinical outcome (modified Rankin Scale, 0–2) at discharge and after 90 days. A total of 48 patients (male: n = 22, 45.8%, mean age 73 years [standard deviation (SD), ±15], median baseline National Institutes of Health Stroke Scale: 15 [2–36], n = 25, 52.1% received additional intravenous thrombolytics) were treated with the APH with a mean number of 2 device passes (SD, +3) in APH-only cases (n = 41). The median time from groin puncture to the final mTICI was 54 minutes (SD, +33). In 46 patients (95.8%), mTICI 2b–3 was achieved (mTICI 2c, 12.5%; mTICI 3, 47.9%). Favorable outcome (modified Rankin Scale <2) was achieved in 15 (32.6%) patients at discharge and in 11 of the 30 (36.7%) patients available for 90-day follow-up. Symptomatic intracranial hemorrhage was recorded in 3 of 48 cases (6.3%). Difficulties during device delivery and/or deployment occurred in 6.3% (3 of 48). APH-related adverse events did not occur. APH radiopacity was rated as good and very good in 97.9% (47 of 48). Mechanical thrombectomy with the APH appeared feasible, efficient, and safe. 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An Early Multicenter Experience</atitle><jtitle>World neurosurgery</jtitle><stitle>WORLD NEUROSURG</stitle><addtitle>World Neurosurg</addtitle><date>2020-09</date><risdate>2020</risdate><volume>141</volume><spage>e278</spage><epage>e288</epage><pages>e278-e288</pages><issn>1878-8750</issn><eissn>1878-8769</eissn><abstract>To investigate the visibility, safety, and efficacy of the full-length radiopaque Aperio Hybrid stent retriever (APH) in mechanical thrombectomy of large vessel occlusions. Multicentric retrospective analysis of patients with stroke, treated with the APH due to an acute ischemic stroke by large vessel occlusions in the anterior or posterior circulation, was performed. We focused on technical and angiographic parameters including device visibility, perfusion results (modified thrombolysis in cerebral infarction scale [mTICI]), procedural times, periprocedural complications, and favorable clinical outcome (modified Rankin Scale, 0–2) at discharge and after 90 days. A total of 48 patients (male: n = 22, 45.8%, mean age 73 years [standard deviation (SD), ±15], median baseline National Institutes of Health Stroke Scale: 15 [2–36], n = 25, 52.1% received additional intravenous thrombolytics) were treated with the APH with a mean number of 2 device passes (SD, +3) in APH-only cases (n = 41). The median time from groin puncture to the final mTICI was 54 minutes (SD, +33). In 46 patients (95.8%), mTICI 2b–3 was achieved (mTICI 2c, 12.5%; mTICI 3, 47.9%). Favorable outcome (modified Rankin Scale <2) was achieved in 15 (32.6%) patients at discharge and in 11 of the 30 (36.7%) patients available for 90-day follow-up. Symptomatic intracranial hemorrhage was recorded in 3 of 48 cases (6.3%). Difficulties during device delivery and/or deployment occurred in 6.3% (3 of 48). APH-related adverse events did not occur. APH radiopacity was rated as good and very good in 97.9% (47 of 48). Mechanical thrombectomy with the APH appeared feasible, efficient, and safe. Full-length device radiopacity may facilitate thrombectomy or support to adapt the course of action during retrieval, if required.</abstract><cop>NEW YORK</cop><pub>Elsevier Inc</pub><pmid>32434034</pmid><doi>10.1016/j.wneu.2020.05.104</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-2620-7611</orcidid><orcidid>https://orcid.org/0000-0003-3712-2258</orcidid><orcidid>https://orcid.org/0000-0002-3118-7627</orcidid><orcidid>https://orcid.org/0000-0002-4710-2317</orcidid><orcidid>https://orcid.org/0000-0002-5245-4958</orcidid></addata></record>
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subjects	Aged Aperio Hybrid Clinical Neurology Endovascular Procedures - instrumentation Female Humans Ischemic stroke Life Sciences & Biomedicine Male Mechanical thrombectomy Middle Aged Neurosciences & Neurology Recanalization Retrospective Studies Science & Technology Stent retriever Stroke - surgery Surgery Thrombectomy - instrumentation
title	The New Fully Radiopaque Aperio Hybrid Stent Retriever: Efficient and Safe? An Early Multicenter Experience
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