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Akpınar ÇK, Gurkas E, Ozdemir AO, Doğan H, Önalan A, Yıldırım S, Memiş Z, Aytaç E, Acar BA, Öğün MN, Aykaç Ö, Uysal Kocabaş Z, Acar T, Eryılmaz HA, Topaktaş B. Three years' interventional neurology experience in Turkey with the Thrombite thrombectomy device in large vessel occlusion in the anterior circulation: safety, efficacy, and clinical outcome. Front Neurol 2024; 15:1320510. [PMID: 38765260 PMCID: PMC11100768 DOI: 10.3389/fneur.2024.1320510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 01/10/2024] [Indexed: 05/21/2024] Open
Abstract
Introduction While the Thrombite device differs from the Solitare stent with its Helical open-side structure feature, it shows great similarity with its other features. We assessed the Thrombite device's effectiveness and safety in this study. Materials and methods The study was a retrospective analysis of patients who were included in the Turkish Interventional Neurology database and who had mechanical thrombectomy with the Thrombite device as the first choice between January 2020 and January 2023. The type of study is descriptive research. Result Using the Thrombite thrombectomy device, 525 patients received treatment. The median baseline National Institutes of Health Stroke Scale (NIHSS) score was 13, the median initial Alberta Stroke Program Early Computed Tomography (ASPECT) score was 8, and the mean patient age was 68.6+11.7 years. Between the groin puncture and the successful recanalization, the median time was 34 minutes (interquartile range [IQR]: 15-45). 48.2% (modified treatment in cerebral infarction; mTICI) 2b/3% and 33.9% (mTICI 2c/3) were the first-pass recanalization rates. In the end, 87.7% of patients had effective recanalization (thrombolysis in cerebral infarction 2b/3). In the "first-pass" subgroup, the favorable functional result (modified Rankin Scale 0-2) was 51.8%, while it was 41.6% for the entire patient population. The rate of embolization into new territory/different territory were 2.1/0.1%. 23 patients (4.5%) had symptomatic hemorrhage. Conclusion The Thrombite device showed a good safety profile and high overall successful recanalization rates in our experience.
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Affiliation(s)
- Çetin Kürşad Akpınar
- Samsun Tranining and Research Hospital, Stroke Center, Department of Neurology, Samsun University, Samsun, Türkiye
| | - Erdem Gurkas
- Kartal Dr. Lütfi Kırdar City Hospital, Stroke Center, Department of Neurology, Health Sciences University, İstanbul, Türkiye
| | - Atilla Ozcan Ozdemir
- Eskisehir Osmangazi University Hospital, Stroke Center, Department of Neurology, Eskişehir Osmangazi University, Eskişehir, Türkiye
| | - Hasan Doğan
- Samsun Tranining and Research Hospital, Stroke Center, Department of Neurology, Samsun University, Samsun, Türkiye
| | - Ayşenur Önalan
- Kartal Dr. Lütfi Kırdar City Hospital, Stroke Center, Department of Neurology, Health Sciences University, İstanbul, Türkiye
| | | | - Zülfikar Memiş
- Haseki Training and Research Hospital, Stroke Center, Department of Neurology, Health Sciences University, İstanbul, Türkiye
| | - Emrah Aytaç
- Fırat University Hospital, Stroke Center, Department of Neurology, Elazığ, Türkiye
| | - Bilgehan Atılgan Acar
- Sakarya University Hospital, Stroke Center, Department of Neurology, Sakarya, Türkiye
| | - Muhammed Nur Öğün
- Abant İzzet Baysal University Hospital, Stroke Center, Department of Neurology, Bolu, Türkiye
| | - Özlem Aykaç
- Eskisehir Osmangazi University Hospital, Stroke Center, Department of Neurology, Eskişehir Osmangazi University, Eskişehir, Türkiye
| | - Zehra Uysal Kocabaş
- Eskisehir Osmangazi University Hospital, Stroke Center, Department of Neurology, Eskişehir Osmangazi University, Eskişehir, Türkiye
| | - Türkan Acar
- Sakarya University Hospital, Stroke Center, Department of Neurology, Sakarya, Türkiye
| | - Halil Alper Eryılmaz
- Sakarya University Hospital, Stroke Center, Department of Neurology, Sakarya, Türkiye
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Melki GJ, Demeestere J, Laenen A, Bonne L, Claus E, Lambert J, Buyck PJ, Peluso J, Demaerel P, Lemmens R, Maleux G. Immediate and 90-Day Clinical Outcome of Patients with Acute Stroke Treated with the NeVa-Vesalio Mechanical Thrombectomy Device: A Retrospective Case Series. World Neurosurg 2023; 179:e212-e221. [PMID: 37611801 DOI: 10.1016/j.wneu.2023.08.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVE The NeVa stent retriever is a newly designed mechanical thrombectomy device for the treatment of acute ischemic stroke caused by large vessel occlusion. We investigate the procedural characteristics and patients' clinical outcomes at discharge and at 90 days of follow-up. METHODS We retrospectively reviewed a cohort of 75 patients (median age, 74 years) treated with the NeVa device for acute large vessel occlusion stroke. Per pass modified Treatment in Cerebral Infarction (mTICI) scores, procedural complications, and clinical outcome parameters including the National Institutes of Health Stroke Scale (NIHSS) score, modified Rankin Scale (mRS) score, and mortality were analyzed, based on patients' electronic medical records. RESULTS Complete first pass effect was observed in 24 patients (32%). Vasospasm, repeated re-thrombosis, failure to advance the NeVa device through the microcatheter, and symptomatic intracranial hemorrhage were observed in 2, 1, 1, and 2 patient(s) respectively. The rate of complete (mTICI 2c-3) reperfusion was achieved in 61 patients (81.33%), with a median number of 2 passes (1-3). Median NIHSS score on admission, after 24 hours, and after 5-10 days or at discharge was 19 (15-23), 11 (4-19), and 3 (2-13.5), respectively. The number of patients with a functional mRS score (0-2) at 90 days follow-up was 29 (39%). CONCLUSIONS Endovascular stroke management with use of the NeVa-Vesalio stent retriever may be associated with a 90-day functional mRS score in nearly 40% of treated patients.
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Affiliation(s)
| | - Jelle Demeestere
- Department of Neurology, University Hospitals KU Leuven, Leuven, Belgium
| | - Annouschka Laenen
- Department of Public Health and Primary Care, Leuven Biostatistics and Statistical Bioinformatics Centre, Leuven, Belgium
| | - Lawrence Bonne
- Department of Radiology, University Hospitals KU Leuven, Leuven, Belgium
| | - Eveline Claus
- Department of Radiology, University Hospitals KU Leuven, Leuven, Belgium
| | - Julie Lambert
- Department of Radiology, University Hospitals KU Leuven, Leuven, Belgium
| | - Pieter-Jan Buyck
- Department of Radiology, University Hospitals KU Leuven, Leuven, Belgium
| | - Jo Peluso
- Department of Radiology, University Hospitals KU Leuven, Leuven, Belgium
| | - Philippe Demaerel
- Department of Radiology, University Hospitals KU Leuven, Leuven, Belgium
| | - Robin Lemmens
- Department of Neurology, University Hospitals KU Leuven, Leuven, Belgium
| | - Geert Maleux
- Department of Radiology, University Hospitals KU Leuven, Leuven, Belgium.
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