Benefit of mechanical thrombectomy in acute ischemic stroke related to calcified cerebral embolus - 18/06/22
Abstract |
Summary purpose |
Mechanical thrombectomies (MT) in patients with large vessel occlusion (LVO) related to calcified cerebral embolus (CCE) have been reported, through small case series, being associated with low reperfusion rate and worse outcome, compared to regular MT. The purpose of the MASC (Mechanical Thrombectomy in Acute Ischemic Stroke Related to Calcified Cerebral Embolus) study was to evaluate the incidence of CCEs treated by MT and the effectiveness of MT in this indication.
Methods |
The MASC study is a retrospective multicentric (n = 37) national study gathering the cases of adult patients who underwent MT for acute ischemic stroke with LVO related to a CCE in France from January 2015 to November 2019. Reperfusion rate (mTICI ≥ 2B), complication rate and 90-day mRS were systematically collected. We then conducted a systematic review by searching for articles in PubMed, Cochrane Library, Embase and Google Scholar from January 2015 to March 2020. A meta-analysis was performed to estimate clinical outcome at 90 days, reperfusion rate and complications.
Results |
We gathered data from 35 patients. Reperfusion was obtained in 57% of the cases. Good clinical outcome was observed in 28% of the patients. The meta-analysis retrieved 136 patients. Reperfusion and good clinical outcome were obtained in 50% and 29% of the cases, respectively.
Conclusion |
The MASC study found worse angiographic and clinical outcomes compared to regular thrombectomies. Individual patient-based meta-analysis including the MASC findings shows a 50% reperfusion rate and a 29% of good clinical outcome.
El texto completo de este artículo está disponible en PDF.Graphical abstract |
Highlights |
• | Cerebral calcic emboli (CCEs) have been reported in 3% of the acute ischemic stroke. |
• | CCEs’ prevalence is probably underestimated. |
• | CCEs are associated with a poorer reperfusion rate and a worse clinical outcome than regular clots using the currently available thrombectomy techniques. |
Keywords : Calcified cerebral embolus, Mechanical thrombectomy, Reperfusion, Clinical outcome
Esquema
Vol 49 - N° 4
P. 317-323 - juin 2022 Regresar al número
Artículo precedente
- Safety and effectiveness of mechanical thrombectomy for primary isolated distal vessel occlusions: A monocentric retrospective comparative study
- Mahmoud Elhorany, Charlotte Rosso, Eimad Shotar, Flore Baronnet-Chauvet, Kévin Premat, Stéphanie Lenck, Sophie Crozier, Céline Corcy, Laure Bottin, Ossama Yassin Mansour, Atika Talbi, El-Sayed Ali Tag El-din, Wael Ahmed Fadel, Nader-Antoine Sourour, Sonia Alamowitch, Yves Samson, Frédéric Clarençon
- Mechanical thrombectomy with a novel device: initial clinical experience with the ANA thrombectomy device
- Alejandro Tomasello, David Hernandez, Carlos Piñana, Manuel Requena, David S. Liebeskind, Raul G. Nogueira, Tudor Jovin, Tommy Andersson, Christoph Cognard, Adnan Siddiqui, Marc Ribo
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