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Initial Experience of ACE68 Reperfusion Catheter in Patients with Acute Ischemic Stroke Related to Internal Carotid Artery Occlusion
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논문 기본 정보

Type
Academic journal
Author
Jang, Hyoung-Gyu (Departments of Neurosurgery and Research Institute, Clinical Medicine of Chonbuk National University-Biomedical Research Institute, Chonbuk National University Hospital) Park, Jung-Soo (Departments of Neurosurgery and Research Institute, Clinical Medicine of Chonbuk National University-Biomedical Research Institute, Chonbuk National University Hospital)
Journal
대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제62권 제5호 SCOPUS
Published
2019.1
Pages
545 - 550 (6page)

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Initial Experience of ACE68 Reperfusion Catheter in Patients with Acute Ischemic Stroke Related to Internal Carotid Artery Occlusion
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Objective : Penumbra ACE68 reperfusion catheter is a new large bore aspiration catheter used for reperfusion of large vessel occlusion. The objective of this study was to investigate the efficacy of this catheter in comparison to that of previous Penumbra catheters in patients with acute ischemic stroke related to internal carotid artery (ICA) occlusion. Methods : Data of all eligible patients who received endovascular treatment (EVT) for ICA occlusion using Penumbra aspiration catheters between January 2015 and December 2018 were retrospectively reviewed. After dividing into two groups according to use of penumbra ACE68, baseline characteristics of patients, successful recanalization rate, puncture to recanalization time, and switch to stent base technique rate were assessed. Successful recanalization was defined by a thrombolysis in cerebral infarction (TICI) score ${\geq}2b$ and favorable functional outcome was defined according to modified Rankin scale (score, 0-2). Results : ACE68 reperfusion catheter was used in 29 of 75 eligible patients (39%). The puncture to recanalization time was significantly shorter ($26{\pm}18.2$ minutes vs. $40{\pm}24.9$ minutes, p=0.011) and the rate of switch to stent-based retrieval was significantly lower (3% vs. 20%, p=0.046) in ACE68 catheter group. Moreover, although not statistically significant, the successful recanalization rate was higher (83% vs. 76%, p=0.492) in ACE68 catheter group. Favorable functional outcome was observed in 48% of patients treated with ACE68 reperfusion catheter and in 30% of patients treated using other Penumbra systems (p=0.120). Baseline Alberta Stroke Program Early CT Scores ${\geq}8$ (odds ratio [OR], 9.74; 95% confidence interval [CI], 1.72-54.99; p=0.010) and successful recanalization (OR, 10.20; 95% CI, 1.13-92.46; p=0.039) were independent predictors of favorable outcome. Conclusion : EVT using ACE68 reperfusion catheter can be considered a first-line therapy in patients with acute ICA occlusion as it can achieve rapid recanalization and reduce the frequency of conversion to stent-retrieve therapy.
#Stroke #Brain ischemia #Aspiration thrombectomy

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References (12)

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Berkhemer OA / 2015 / A randomized trial of intraarterial treatment for acute ischemic stroke / N Engl J Med 372:11~20 google schola Campbell BC / 2015 / Endovascular therapy for ischemic stroke / N Engl J Med 372:2365~2366 google schola Frei D / 2013 / The SPEED study: initial clinical evaluation of the penumbra novel 054 reperfusion catheter / J Neurointerv Surg 5(Suppl 1):i74~i76 google schola Goyal M / 2015 / Randomized assessment of rapid endovascular treatment of ischemic stroke / N Engl J Med 372:1019~1030 google schola Jankowitz B / 2012 / Manual aspiration thrombectomy: adjunctive endovascular recanalization technique in acute stroke interventions / Stroke 43:1408~1411 google schola

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