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Arterial Collapse during Thrombectomy for Stroke: Clinical Evidence and Experimental Findings in Human Brains and In Vivo Models

Arterial Collapse during Thrombectomy for Stroke: Clinical Evidence and Experimental Findings in... ORIGINAL RESEARCH INTERVENTIONAL Arterial Collapse during Thrombectomy for Stroke: Clinical Evidence and Experimental Findings in Human Brains and In Vivo Models Y. Liu, D. Gebrezgiabhier, Y. Zheng, A.J. Shih, N. Chaudhary, A.S. Pandey, J.L.A. Larco, S.I. Madhani, M. Abbasi, A.H. Shahid, R.A. Quinton, R. Kadirvel, W. Brinjikji, D.F. Kallmes, and L.E. Savastano ABSTRACT BACKGROUND AND PURPOSE: Aspiration thrombectomy has become a preferred approach to recanalize large-vessel occlusion in stroke with a growing trend toward using larger-bore catheters and stronger vacuum pumps. However, the mechanical response of the delicate cerebral arteries to aspiration force has not been evaluated. Here, we provide preclinical and clinical evidence of intra- cranial arterial collapse in aspiration thrombectomy. MATERIALS AND METHODS: We presented a clinical case of arterial collapse with previously implanted flow diverters. We then evaluated the effect of vacuum with conventional aspiration catheters (with and without stent retrievers) in a rabbit model (n¼ 3) using fluoroscopy and intravascular optical coherence tomography. Then, in a validated human cadaveric brain model, we con- ducted 168 tests of direct aspiration thrombectomy following an experimental design modifying the catheter inner diameter (0.064 inch, 0.068 inch, and 0.070 inch), cerebral perfusion pressures (mean around 60 and 90 mm http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

Arterial Collapse during Thrombectomy for Stroke: Clinical Evidence and Experimental Findings in Human Brains and In Vivo Models

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Publisher
American Journal of Neuroradiology
Copyright
© 2022 by American Journal of Neuroradiology
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.A7389
Publisher site
See Article on Publisher Site

Abstract

ORIGINAL RESEARCH INTERVENTIONAL Arterial Collapse during Thrombectomy for Stroke: Clinical Evidence and Experimental Findings in Human Brains and In Vivo Models Y. Liu, D. Gebrezgiabhier, Y. Zheng, A.J. Shih, N. Chaudhary, A.S. Pandey, J.L.A. Larco, S.I. Madhani, M. Abbasi, A.H. Shahid, R.A. Quinton, R. Kadirvel, W. Brinjikji, D.F. Kallmes, and L.E. Savastano ABSTRACT BACKGROUND AND PURPOSE: Aspiration thrombectomy has become a preferred approach to recanalize large-vessel occlusion in stroke with a growing trend toward using larger-bore catheters and stronger vacuum pumps. However, the mechanical response of the delicate cerebral arteries to aspiration force has not been evaluated. Here, we provide preclinical and clinical evidence of intra- cranial arterial collapse in aspiration thrombectomy. MATERIALS AND METHODS: We presented a clinical case of arterial collapse with previously implanted flow diverters. We then evaluated the effect of vacuum with conventional aspiration catheters (with and without stent retrievers) in a rabbit model (n¼ 3) using fluoroscopy and intravascular optical coherence tomography. Then, in a validated human cadaveric brain model, we con- ducted 168 tests of direct aspiration thrombectomy following an experimental design modifying the catheter inner diameter (0.064 inch, 0.068 inch, and 0.070 inch), cerebral perfusion pressures (mean around 60 and 90 mm

Journal

American Journal of NeuroradiologyAmerican Journal of Neuroradiology

Published: Feb 1, 2022

References