• World Neurosurg · Sep 2020

    Multicenter Study Observational Study

    The new fully radiopaque Aperio Hybrid Stent-Retriever: Efficient and safe? An early multicenter experience.

    • Marius Kaschner, Thorsten Lichtenstein, Daniel Weiss, Bernd Turowski, Lukas Goertz, Claudia Kluner, Marc Schlamann, Christian Mathys, and Christoph Kabbasch.
    • Medical Faculty, Department of Diagnostic and Interventional Radiology, University Duesseldorf, Duesseldorf, Germany.
    • World Neurosurg. 2020 Sep 1; 141: e278-e288.

    ObjectiveTo investigate the visibility, safety, and efficacy of the full-length radiopaque Aperio Hybrid stent retriever (APH) in mechanical thrombectomy of large vessel occlusions.MethodsMulticentric 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.ResultsA 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).ConclusionsMechanical 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.Copyright © 2020 Elsevier Inc. All rights reserved.

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