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Interv Neuroradiol. 2016 Jun;22(3):325-32. doi: 10.1177/1591019916632369. Epub 2016 Feb 22.

ARTS (Aspiration-Retriever Technique for Stroke): Initial clinical experience.

Author information

1
Division Neuroimaging and Intervention (NII) and New England Center for Stroke Research, Department of Radiology, University of Massachusetts, Worcester, USA massarimd@gmail.com.
2
Departments of Neurology and Psychiatry, University of Massachusetts, Worcester, USA.
3
Division Neuroimaging and Intervention (NII) and New England Center for Stroke Research, Department of Radiology, University of Massachusetts, Worcester, USA.
4
Department of Neurosurgery, Baylor College of Medicine, Houston, USA.

Abstract

BACKGROUND:

A new generation of highly navigable large-bore aspiration catheters and retriever devices for intracranial mechanical thrombectomy has markedly improved recanalization rates, time and clinical outcomes. We report collected clinical data utilizing a new technique based on combined large lumen aspiration catheter and partially resheathed stent retriever (ARTS: Aspiration (catheter)-(stent) Retriever Technique for Stroke). This technique is applied, especially in presence of bulky/rubbery emboli, when resistance is felt while retracting the stent retriever; at that point the entire assembly is locked and removed in-toto under continuous aspiration with additional flow arrest.

METHODS:

A retrospective data analysis was performed to identify patients with large cerebral artery acute ischemic stroke treated with ARTS. The study was conducted between August 2013 and February 2015 at a single high volume stroke center. Procedural and clinical data were captured for analysis.

RESULTS:

Forty-two patients (median age 66 years) met inclusion criteria for this study. The ARTS was successful in achieving Thrombolysis in Cerebral Infarction (TICI) ≥2b revascularization in 97.6% of cases (TICI 2b = 18 patients, TICI 3 = 23 patients). Patients' median National Institutes of Health Stroke Scale score at admission was 18 (6-40). A 3-month follow-up modified Rankin Scale value of 0-2 was achieved in 65.7% of the successfully treated patients (average 2.4). Two patients (4.8%) developed symptomatic intraparenchymal hemorrhages. Six procedure unrelated deaths were observed.

CONCLUSIONS:

We found that ARTS is a fast, safe and effective method for endovascular recanalization of large vessel occlusions presenting within the context of acute ischemic stroke.

KEYWORDS:

Stroke; TICI; aspiration catheter; mechanical thrombectomy; stent retriever

PMID:
26908591
PMCID:
PMC4984370
DOI:
10.1177/1591019916632369
[Indexed for MEDLINE]
Free PMC Article

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