Publication date: Available online 27 June 2019
Source: Journal of Neuroradiology
Author(s): Silke Hopf-Jensen, Joana Marques, Stephanie Lehrke, Preiß Michael, Stefan Müller-Hülsbeck
Source: Journal of Neuroradiology
Author(s): Silke Hopf-Jensen, Joana Marques, Stephanie Lehrke, Preiß Michael, Stefan Müller-Hülsbeck
Abstract
Purpose: To determine the impact of vessel variation and anatomical features on technical and clinical success.
Materials and Methods: In vitro blood clots (n = 100) were introduced into a silicon carotid-T flow model of 2, 3 or 4 mm. The ICA/M1 angle varied at 45°, 90°, 135° and 180°. Peripheral embolism was measured.
In vivo 50 pat. (73.5 yrs., ±15) with MCA occlusion were examined for siphon variation, ICA morphology, vessel diameter and angles. The patients were divided according to the clinical success (mRS): group A: mRS≤2 after 90 day and group B: mRS≥3. Furthermore the technical success (TICI) and number of retrieval (n) were analysed.
Results: In vitro with larger vessel diameter the migrated thrombus load decreased (P = .001). The steeper the M1/ICA angles, the higher thrombus weighs (180 °: 2.94 mg; 135 °: 6.32 mg; 90 °: 8.65 mg, 45 °: 10.69 mg; P < .001).
In vivo patients with mRS≤2 had significantly lower NIHSS (16.5 vs. 20, P= .009) and higher ASPECTS (9 vs. 6, P< .05). TICI ≥2b was more often achieved (86.6 vs. 40% P= .002). The procedure time was lower (45 vs. 80 min, P< .05) with smaller number of retrieval (1.5 vs. 4, P< .05). Proximal ICA stenosis offers a trend to unfavourable outcome (P= .073). Siphon variation “D” is associated with less retrieval manoeuvre.
Conclusion: While in vitro there is a close correlation between embolism and vascular anatomy, in vivo carotid artery stenosis and siphon variation influence clinical and technical success.
Materials and Methods: In vitro blood clots (n = 100) were introduced into a silicon carotid-T flow model of 2, 3 or 4 mm. The ICA/M1 angle varied at 45°, 90°, 135° and 180°. Peripheral embolism was measured.
In vivo 50 pat. (73.5 yrs., ±15) with MCA occlusion were examined for siphon variation, ICA morphology, vessel diameter and angles. The patients were divided according to the clinical success (mRS): group A: mRS≤2 after 90 day and group B: mRS≥3. Furthermore the technical success (TICI) and number of retrieval (n) were analysed.
Results: In vitro with larger vessel diameter the migrated thrombus load decreased (P = .001). The steeper the M1/ICA angles, the higher thrombus weighs (180 °: 2.94 mg; 135 °: 6.32 mg; 90 °: 8.65 mg, 45 °: 10.69 mg; P < .001).
In vivo patients with mRS≤2 had significantly lower NIHSS (16.5 vs. 20, P= .009) and higher ASPECTS (9 vs. 6, P< .05). TICI ≥2b was more often achieved (86.6 vs. 40% P= .002). The procedure time was lower (45 vs. 80 min, P< .05) with smaller number of retrieval (1.5 vs. 4, P< .05). Proximal ICA stenosis offers a trend to unfavourable outcome (P= .073). Siphon variation “D” is associated with less retrieval manoeuvre.
Conclusion: While in vitro there is a close correlation between embolism and vascular anatomy, in vivo carotid artery stenosis and siphon variation influence clinical and technical success.
Publication date: Available online 27 June 2019Source: Journal of NeuroradiologyAuthor(s): Silke Hopf-Jensen, Joana Marques, Stephanie Lehrke, Preiß Michael, Stefan Müller-HülsbeckAbstractPurpose: To determine the impact of vessel variation and anatomical features on technical and clinical success.Materials and Methods: In vitro blood clots (n = 100) were introduced into a silicon carotid-T flow model of 2, 3 or 4 mm. The ICA/M1 angle varied at 45°, 90°, 135° and 180°. Peripheral embolism was measured.In...
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