2019 Volume 24 Issue 2 Pages 157-164
Endovascular thrombectomy using a stent‒retriever or aspiration catheter has become the standard treatment for ischemic stroke due to large‒vessel occlusion in the anterior circulation excluding the middle cerebral artery M2 segment. Although some techniques simultaneously using a stent‒retriever and aspiration catheter have been reported, few studies have compared this combined technique with the conventional technique. The present study compared the efficacy of the combined and conventional techniques by occlusion site. The cases of the 51 consecutive patients with occlusion of the anterior circulation treated with endovascular thrombectomy at our institute from August 2014 to December 2018 were evaluated. A stent‒retriever had been used as the first‒line device until August 2017 (n＝31), and then the combined technique was used since September 2017 (n＝20). The clinical outcomes and successful reperfusion rates were compared between the two groups overall and by occlusion site. Overall, the successful reperfusion rate (80% vs. 81%) and favorable outcomes (50% vs. 42%) were similar between the two groups. Although the favorable outcome rate and the reperfusion rate were similar between the two groups for M2 occlusion and other occlusion sites, the procedure time was significantly longer (83 vs. 59 min, p＝0.025) for M2 occlusion and tended to be shorter (58 vs. 68 min, p＝0.078) for other occlusion sites. The combination technique may thus be a promising treatment for acute ischemic stroke due to proximal artery occlusion and may be somewhat inferior for distal artery occlusion.
