title: Manual aspiration thrombectomy using a Penumbra catheter in patients with acute migrated MCA occlusion.
abstract: Background We retrospectively assessed the efficacy and safety of manual aspiration thrombectomy (MAT) using a Penumbra catheter in patients with acute migrated middle cerebral artery (MCA) occlusion. Methods We conducted a retrospective review of patients who underwent MAT using Penumbra 4 or 5 MAX reperfusion catheters for the treatment of acute MCA occlusion between January 2012 and December 2015. A migrated thrombus was defined as distal migration greater than ≥1 cm on initial cerebral angiography compared with preprocedural angiographic findings. We evaluated immediate angiographic results and clinical outcomes through a review of electronic medical records and compared clinical outcomes between migrated and non-migrated MCA occlusions. Results During this period, 98 patients underwent MAT using Penumbra catheters for treatment of acute MCA occlusions. Of these, 19 (19.4%) had a migrated MCA thrombus on initial cerebral angiography compared with preprocedural angiographic findings. The overall rate of successful recanalization (TICI grade ≥ 2b) was 90.8%. The rate of successful recanalization in the migrated thrombus group was 94.7% (18/19). Overall procedure time for recanalization in the migrated thrombus group was significantly shorter than that in the non-migrated thrombus group ( p = 0.001). Although the difference was not significant, there was a trend toward more favorable clinical outcomes in the migrated thrombus group compared to the non-migrated thrombus groups (78.9% versus 60.8%, p = 0.231). Conclusion MAT appears to be safe and can achieve a high rate of successful recanalization and favorable clinical outcomes with short procedure time and without serious complications in patients with acute migrated MCA occlusion.
authors.affiliation: 1 Radiology, Chonbuk National University Medical School and Hospital, Republic of Korea.
authors.forename: Sung Hyun
authors.initials: SH
authors.lastname: Baik
authors.affiliation: 1 Radiology, Chonbuk National University Medical School and Hospital, Republic of Korea.|2 Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Republic of Korea.
authors.forename: Hyo Sung
authors.initials: HS
authors.lastname: Kwak
authors.affiliation: 1 Radiology, Chonbuk National University Medical School and Hospital, Republic of Korea.|2 Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Republic of Korea.
authors.forename: Seung Bae
authors.initials: SB
authors.lastname: Hwang
authors.affiliation: 1 Radiology, Chonbuk National University Medical School and Hospital, Republic of Korea.|2 Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Republic of Korea.
authors.forename: Gyung Ho
authors.initials: GH
authors.lastname: Chung
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D057785:Catheters; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D012189:Retrospective Studies; D020521:Stroke / Q000000981:diagnostic imaging / Q000601:surgery*; D017131:Thrombectomy / Q000295:instrumentation*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Middle cerebral artery; stroke; thrombectomy