Use of a Compliant Balloon for Large Bore Catheter Navigation in Mechanical Thrombectomy for Stroke: a Retrospective Study
se of ADAPT Assisted by a Compliant Balloon (ADAPT-AB) When ADAPT Fails for Acute Stroke Thrombectomy
The superiority of mechanical thrombectomy (MT) in patients with acute ischemic stroke from large vessel occlusion compared to standard medical therapy alone has been demonstrated by several randomized clinical trials and become the standard of care for these patients. A direct aspiration first pass technique (ADAPT) for the endovascular treatment of stroke using a large-bore catheter has been reported to be an effective method of achieving MT. Recent studies reported that ADAPT is as efficient and safe as stent retrievers, with a similar successful recanalization rate, but may have better functional outcomes, fewer procedure related-adverse events, and a tendency for faster revascularization compared to the stent-retriever thrombectomy.
However, navigation of a large-bore aspiration catheter is not always possible due to unsuccessful passage of the ophthalmic artery origin ("ledge effect") or tortuous vascular anatomy. The coaxial technique comprises guiding the large-bore catheter with a smaller inner catheter and can facilitate distal access. However, there is a gap between the inner catheter and the distal tip of the large-bore outer catheter that creates a risk of damaging the vessel wall and causing dissection or subarachnoid hemorrhage. Even with this coaxial technique, it is not always possible to reach the clot site with the large-bore catheter. To decrease the gap between the two catheters, several authors have used, in place of the inner microcatheter, a compliant balloon catheter positioned and inflated at the distal tip of the large-bore catheter. The aim of the present study was to evaluate the safety and efficacy of ADAPT assisted by a compliant balloon (ADAPT-AB) when ADAPT using the coaxial technique fails to reach the clot site.
研究概览
研究类型
注册 (实际的)
联系人和位置
学习地点
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Nice、法国、06000
- CHU de Nice
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
取样方法
研究人群
描述
Inclusion Criteria:
- Endovascular therapy were large arterial occlusions proven by MR angiography,
- Alberta Stroke Program Early CT Score (ASPECTS) >5 on MRI,
- Baseline National Institutes of Health Stroke Scale (NIHSS) score >5.
If eligible, patients received intravenous thrombolysis (IVT).
Exclusion criteria:
- Vertebro-basilar occlusion
学习计划
研究是如何设计的?
设计细节
队列和干预
团体/队列 |
干预/治疗 |
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Mechanical thrombectomy
Patients who underwent mechanical thrombectomy for large vessel occlusion of the anterior circulation
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Use of a compliant balloon when ADAPT fails to reach the clot site
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
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Efficacity to reach the clot site when using an inner balloon
大体时间:Day 0
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Number of patients for whom the balloon made it possible to reach the clot
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Day 0
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
---|---|---|
Clinical status at 3 month
大体时间:Month 3
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Modified Rankin Score
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Month 3
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Endovascular Complication
大体时间:Day 0
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Number of dissection or vasospasm when using the balloon
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Day 0
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合作者和调查者
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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Compliant balloon的临床试验
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Caritasklinik St. Theresia未知
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Fondazione Evidence per Attività e Ricerche Cardiovascolari...未知