Interventional Neuroradiology最新文献

{"title":"Transradial versus transfemoral access for mechanical thrombectomy: A single institution experience.","authors":"Richard Bram, James W Nie, Peter Theiss, Dario Marotta, Maureen Hillman, Ali Alaraj, Gursant S Atwal","doi":"10.1177/15910199241298725","DOIUrl":"10.1177/15910199241298725","url":null,"abstract":"<p><p>BackgroundThere has been debate in the literature regarding the adoption of a \"radial-first\" approach for mechanical thrombectomy (MT) in acute ischemic stroke (AIS). Conflicting reports suggest that transradial access (TRA) may allow for shorter times to reperfusion while others conclude that long-term functional outcomes may favor transfemoral access (TFA). Here, we report a single-institution experience with the adoption of TRA as the primary route for acute stroke intervention.MethodsWe retrospectively reviewed a single-institution database of patients undergoing MT for AIS from March 2020 to April 2023. This time period was selected to capture the change in clinical practice at our institution from TFA to TRA. Primary and secondary outcomes included technical success, procedural complications, and long-term functional outcomes. Patients were stratified into two cohorts from initial access. Cohorts were compared utilizing inferential statistics.ResultsA total of 192 consecutive cases were identified, with 80 in the TFA cohort and 112 in the TRA cohort. There was no difference in outcomes with respect to time from puncture to recanalization, rates of successful recanalization (TICI ≥ 2b), number of passes, rates of symptomatic intracranial hemorrhage (sICH), modified Rankin scale (mRS) at discharge and 90 days, and 90-day mortality (<i>p</i> ≥ 0.05, all). The TRA had a higher rate of access conversion (<i>p</i> < 0.001), while the TFA cohort had a higher rate of access site complications (<i>p</i> < 0.05).</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"2530-2536"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The NeVa stent-retriever - a single-centre real-world experience.","authors":"Pervinder Bhogal, Marco Mancuso-Marcello, Rory Fairhead, Katherine Parkin, Giovanna Klefti, Levansri Makalanda, Ken Wong, Joseph Lansley, Karthikeyan Vanchilingham, Michael Przyszlak, Rukhtam Saqib, Oliver Spooner","doi":"10.1177/15910199251337176","DOIUrl":"10.1177/15910199251337176","url":null,"abstract":"<p><p>Stent-retriever-based mechanical thrombectomy (MT) is an effective treatment for acute ischemic stroke (AIS) caused by large vessel occlusion (LVO). First-pass effect (FPE) is one most powerful predictors of positive outcomes in LVO AIS patients treated with MT. We performed an independent central reader review of our prospectively maintained database to identify all patients treated first with the NeVa stent retriever at our single high-volume Comprehensive Stroke Centre.Overall, 89 patients met our inclusion criteria. The median age was 73 yrs (range 28-88; 52% male). The median presentation NIHSS was 16 (range 5-30) and 49% received IV tPA prior to MT. 93% of target occlusions were in the anterior circulation (<i>n</i> = 83) with a median ASPECT score on plain CT of 8 (range 5-10). A Balloon Guide Catheter (BGC) was used in 80% of cases and a distal aspiration catheter was used in all cases. Longer NeVa models (≥29 mm) were used in 89% of cases. FPE was demonstrated in 57% of cases (eTICI score of ≥2c) with modified FPE demonstrated in 65.1% of cases (eTICI score of ≥2b (67%)). A final eTICI score of ≥2c was achieved in 87% of cases. Good functional outcome (mRS ≤2) was achieved in 40% of patients (<i>n</i> = 81).The NeVa stent-retriever has a very high rate of FPE and final recanalization in this real-world cohort of patients from the NeVa One registry. These results are higher than those previously published and may support longer NeVa device use with a BGC and proximal aspiration to optimize FPE.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"2792-2800"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Onyx Frontier^™ for intracranial stenting in stroke patients: A multicenter retrospective study.","authors":"Ahmad Chahine, Rami Z Morsi, Sonam Thind, Omar Kass-Hout, Tibor Becske, Ahmad Khaldi, Lina Karar, Archit Baskaran, Julián Carrión-Penagos, Harsh Desai, Sachin A Kothari, Rohini Rana, Okker Verhagen Metman, Jehad Zakaria, Atman P Shah, Jonathan D Paul, Sandeep Nathan, James E Siegler, Scott J Mendelson, Ali Mansour, Michael C Hurley, Shyam Prabhakaran, Rishi Gupta, Tareq Kass-Hout","doi":"10.1177/15910199241286922","DOIUrl":"10.1177/15910199241286922","url":null,"abstract":"<p><p>BackgroundAcute ischemic stroke (AIS) due to intracranial atherosclerotic disease (ICAD) carries a high risk of recurrence despite aggressive medical management. The aim of our study is to present our initial experience with the Onyx Frontier™ balloon-mounted drug-eluting stent (Medtronic, Santa Rosa, CA) for AIS due to ICAD.MethodsWe conducted a multicenter retrospective cohort study describing the technical feasibility, safety, and performance of using the Onyx Frontier™ balloon-mounted drug-eluting stent in patients with acute intracranial vessel occlusion due to ICAD across three comprehensive stroke centers in the United States.ResultsWe included 23 patients in our study (mean age 67.3 [10.7]; females: n = 13/23, 56.5%). Most patients were Black (n = 14/23, 60.9%). The most common site of vessel occlusion was the M1 branch of the middle cerebral artery (MCA) (n = 14/23, 60.9%), followed by the vertebrobasilar system (n = 5/23, 21.7%), and the internal carotid artery (n = 3/23, 13.0%). Treatment with the Onyx Frontier™ stent was associated with a final mTICI score ≥2b for 100% of patients, with no vessel perforations or distal embolization. None of the patients had any restenosis or re-treatment over a median follow-up of 3.5 months (interquartile range [IQR] 7.8). All cases required a single stent except for one, where two were deployed. Transfemoral access was used in most cases (n = 18/23, 78.3%), with one in-hospital death due to access site complication (n = 1/23, 4.3%).ConclusionsThis is the largest multicenter cohort study demonstrating the feasibility and safety of using the Onyx Frontier™ balloon-mounted zotarolimus-eluting stent to treat symptomatic AIS due to ICAD.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"2505-2514"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor, regarding \"Navigating the distal vasculature: Challenges and lessons learned from failed thrombectomy trials\" recently published by Sporns and colleagues.","authors":"René Chapot, Ahmed Ayad, Senta Frol","doi":"10.1177/15910199251384470","DOIUrl":"10.1177/15910199251384470","url":null,"abstract":"","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"2897-2898"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of aspiration catheter inner diameter on first-pass effect: A systematic review and meta-analysis.","authors":"Seyed Behnam Jazayeri, Abdullah Reda, Jonathan Cortese, Abdelrahman Reda, Seyed Farzad Maroufi, Sherief Ghozy, Ramanathan Kadirvel, David F Kallmes","doi":"10.1177/15910199251345637","DOIUrl":"10.1177/15910199251345637","url":null,"abstract":"<p><p>BackgroundThe first-pass effect (FPE) refers to the complete or near-complete revascularization with a single pass of mechanical thrombectomy devices. While previous claims suggest a link between larger catheters and the effectiveness of contact aspiration (CA) thrombectomy, no extensive research has confirmed if larger distal inner diameter (ID) catheters achieve higher FPE rates.MethodsWe searched PubMed, Scopus, and Web of Science to assess the impact of aspiration catheter distal ID size on FPE. The primary outcome was FPE rate, defined as thrombolysis in cerebral ischemia (TICI) grades 2c-3 at first pass, and the secondary outcome was modified FPE (TICI 2b-3 in a single pass). Aspiration catheters were categorized based on distal ID: 0.060-0.069 (medium bore), 0.070-0.074 (large bore), and greater than 0.074 inches (super-large bore). Rates of FPE were pooled using random effect models and compared using a Chi-square test.ResultsOur study included 34 articles with 4831 patients. FPE rates were 27.7% (95% CI, 15.1-45.3) for medium bore, 46.6% (95% CI, 33.7-59.9) for large, and 58.3% (95% CI, 44.8-70.7) for super-large catheters. The FPE rate was significantly higher for super-large bore catheters compared with other groups (χ² = 7.26, p = 0.03). A similar trend was observed for modified FPE rates, which were 51.1% (95% CI, 45.3-56.8) for medium bore, 60.0% (95% CI, 52.8-66.8) for large bore, and 80% (95% CI, 56.3-94.2) for super-large bore catheters (χ² = 8.14, p = 0.03).ConclusionOur analysis indicates that larger CA catheters are correlated with higher FPE rates.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"2689-2697"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of anesthesia choice during thrombectomy for distal and medium vessel occlusions: A systematic review and meta-analysis.","authors":"Ahmed Alkhiri, Fahad N Alrajban, Asayel A Alghamdi, Mohammed A Alqahtani, Ibrahim M Al Dahnin, Joud A Osailan, Lamya M Almobty, Jasmine S Alrashidy, Yasir M Aljadani, Ali H Alnajim, Raef A Alharbi, Mishari S Alqahtani, Yasser Aladdin, Seraj Makkawi","doi":"10.1177/15910199251342667","DOIUrl":"10.1177/15910199251342667","url":null,"abstract":"<p><p>BackgroundPhysicians may opt for general anesthesia (GA) during endovascular thrombectomy (EVT) when treating distal and medium vessel occlusion (DMVO), particularly in agitated patients where accessing small vessels presents challenges. However, little is known about how GA and non-GA approaches compare in terms of safety, efficacy, and procedural outcomes for DMVO patients undergoing EVT.MethodsThis systematic review and meta-analysis conform to the established guidelines and protocols for this type of data synthesis. We searched Medline, Embase, Web of Science, and the Cochrane Library up to August 2024. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects models.ResultsSix studies with 3019 patients fit the selection criteria. Of the included patients, 883 (29.2%) were treated under GA. The median age of participants ranged from 68 to 76 years, with median initial National Institute for Health Stroke Scale scores varying from 4 to 15.5. There was no statistically significant difference in terms of good functional outcomes (modified Rankin scale 0-2 at 90 days) between the two groups (OR, 0.97 [95% CI, 0.72-1.30]; <i>p</i> = 0.83). Recanalization metrics and procedural complications were similar between groups. Patients treated under GA had higher 90-day mortality (OR, 1.98, [95% CI 1.43-2.72]; <i>p</i> < 0.01).ConclusionIn this study, both anesthesia methods demonstrated comparable effectiveness; however, GA was associated with higher 90-day mortality. Additional robust evidence is needed to validate these findings and establish their clinical significance across different subgroups of DMVO.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"2671-2678"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-thrombectomy rehabilitation strategies and 90-day outcomes in acute ischemic stroke patients enrolled in randomized controlled trials: A systematic review and meta-analysis.","authors":"Muhammad Shakir, Moeez Ahmed, Zayan Alidina, Yilun Huang, Chun Shing Kwok, Bruce Ovbiagele, Shawn S Wallery, Daniel E Ford, Camilo R Gomez, Daniel F Hanley, Adnan I Qureshi","doi":"10.1177/15910199251341648","DOIUrl":"10.1177/15910199251341648","url":null,"abstract":"<p><p>BackgroundThe post-thrombectomy recovery phase has significant influence on long-term patient outcomes. Our study aims to explore the effect of post-thrombectomy rehabilitation strategies on modified Rankin Scale (mRS) at 90-day.MethodsA search of PubMed, Scopus, Web of Science, ClinicalTrials.gov, and the Cochrane Library from inception to April 2024. Randomized controlled trials (RCTs) were included and assessed for quality using the Cochrane risk of bias tool. The rehabilitation strategies were divided into three groups: as per institutional care, as per national guideline, or not specified. We performed meta-regression to identify the association between rehabilitation strategy used and 90-day outcome defined using mRS.Results23 RCTs were included with 6649 patients (mean age 67 and 26% of patients were men). Rehabilitation \"as per institutional care\" was the most common (52%, 95% confidence interval (CI):31%-72%), followed by \"as per national guidelines\" (17%, 95% CI:5%-39%). We found statistically significant variations in proportions of rehabilitation strategies (<i>F</i>(2,97) = 0.035, <i>p</i> = 0.01). A two-proportion z-test indicated a borderline significant difference between \"as per institutional care\" (52%) and \"as per national guidelines\" (17%) (χ²(1) = 3.52, <i>p</i> = 0.06). In meta-regression, rehabilitation strategies used in the RCT significantly influenced the proportion of patients enrolled in the RCT who achieved mRS 0-2 at 90 days post-thrombectomy (QM (df = 1) = 5.06, <i>p</i> = 0.025). Trials using rehabilitation \"as per institutional care\" (log odds ratio (OR) = 0.64, 95% CI [0.42, 0.87], <i>p</i> < 0.01) and those using rehabilitation \"as per national guidelines\" (log odds ratio = 0.58, 95% CI [0.07-1.08], <i>p</i> = 0.02) were associated with statistical significantly higher odds of having higher proportion of patients with mRS 0-2 at 90 days.ConclusionsThere is variation in rehabilitation strategies utilized post-thrombectomy which influences functional outcomes at 90 days. Rehabilitation protocols should be standardized in RCTs evaluating thrombectomy in acute ischemic stroke patients.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"2659-2670"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aspiration tubing diameter is a key determinant of vacuum pressure and is associated with procedural outcome in mechanical thrombectomy for large vessel occlusion: An experimental and cohort study.","authors":"Leonard H Verhey, Leah Lyons, Andrea Sewell, Ryan M Grandfield, Muhib Khan, Paul Mazaris, Justin A Singer","doi":"10.1177/15910199241272715","DOIUrl":"10.1177/15910199241272715","url":null,"abstract":"<p><p>BackgroundWe (1) evaluated the effect of aspiration tubing diameter on intraluminal pressure and (2) compared thrombectomy outcomes in patients treated using small diameter tubing versus those treated using large diameter vacuum tubing.MethodsIntraluminal negative pressure was measured in a validated benchtop set up where consistency of negative pressure (inHg) was measured between static and dynamic aspiration. Static aspiration refers to activation of vacuum once the catheter is engaged with the clot. Dynamic aspiration refers to activation of vacuum when the catheter is slightly proximal to the clot. Four different sizes of vacuum tubing were trialed. We performed a retrospective analysis of consecutive patients who underwent mechanical thrombectomy. Procedural and functional outcomes were compared.ResultsThe large diameter aspiration tubing held a consistent high negative pressure in static and dynamic aspiration (p = 0.152). Tubing types I to III were associated with a significant fall off in negative pressure between static and dynamic technique (p < 0.05). Two-hundred and five patients were included in the retrospective analysis; 124 (60%) underwent thrombectomy using small diameter vacuum tubing, and 81 (40%) using the large tubing. Mean thrombectomy time was shorter with the larger tubing [25.9 (17.9) minutes] versus the small tubing [37.5 (28.5) minutes, p = 0.002]. A greater proportion of patients had a thrombolysis in cerebral infarction score ≥2b in the group treated using the large tubing (78, 99%) than those with the small tubing (96, 78%, p < 0.001).ConclusionVacuum tubing diameter is linearly associated with intraluminal aspiration pressure. These findings have clinical significance as shown by increased recanalization rates and decreased thrombectomy times when large-diameter aspiration tubing is used. Shifting the paradigm toward a flow-based technique using large-bore vacuum tubing ought to be considered.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"2245-2251"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in blood biochemistry thrombosis parameters 24 hours after stent-assisted endovascular treatment of intracranial aneurysms.","authors":"Celal Cinar, Ismail Oran, Halil Ibrahim Ozdemir, Mahmut Kusbeci, Ramazan Kaan Kavakli, Mahmut Tobu, Zuhal Parildar","doi":"10.1177/15910199241272522","DOIUrl":"10.1177/15910199241272522","url":null,"abstract":"<p><p>Background and purposeThis study aims to elucidate the early changes in blood biochemistry thrombosis parameters following stent-assisted endovascular treatment of intracranial aneurysms.MethodsConsecutive patients with unruptured aneurysms undergoing stent implantation during endovascular treatment were included in this prospective study with approval from the local ethics committee. Blood samples were collected immediately before and 24 h after the procedure for biochemical analysis, including basic thrombosis indicators, bleeding tests, and a complete blood count.ResultsThe study included 80 patients (60 women, 20 men) with 134 aneurysms. A total of 135 stents (110 flow-diverting, 25 standard) were used. Additionally, intrasaccular coiling was utilized in 28 aneurysms among 27 patients. Following the procedure, there was a significant decrease in activated partial thromboplastin time, fibrinogen, hemoglobin, and platelet levels, and a significant increase in prothrombin time, D-dimer, von Willebrand factor (vWF) activity/antigen ratio, and leukocyte levels in all patients. Correlation analyses revealed significant positive associations between platelet and fibrinogen levels, and a negative association between D-dimer and fibrinogen levels in the coil (-) group. Additionally, there was a significant negative correlation between aneurysm volume and vWF activity/antigen ratio, and procedure duration and thrombocyte count, while a positive association was found between aneurysm number and leukocyte count in the coil (-) group.ConclusionsAnalysis of blood chemistry alterations indicates that intravascular thrombosis occurs in the intracranial circulation following stent-assisted endovascular treatment of intracranial aneurysms. This thrombotic process is more pronounced in patients whose aneurysms were left open (i.e. flow-diverting stent alone).</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"2190-2197"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing thrombectomy in medium vessel occlusion: Focus on vessel diameter.","authors":"Yujiro Tanaka, Daisuke Watanabe, Yusuke Kanoko, Aya Inoue, Daichi Kato, Shota Igasaki, Akira Kikuta, Motoyori Ogasawara, Kodai Kanemaru, Hibiku Maruoka","doi":"10.1177/15910199241272638","DOIUrl":"10.1177/15910199241272638","url":null,"abstract":"<p><p>ObjectivesMechanical thrombectomy for medium vessel occlusion (MeVO) is a challenging field with limited results. In this study, we aimed at evaluating the efficacy and safety of a procedural strategy beginning with occluded vessel diameter measurement and matched aspiration catheter selection.Materials and MethodsWe retrospectively analyzed all sequentially treated patients by mechanical thrombectomy at two comprehensive stroke centers between May 2020 and April 2023, focusing on the occluded vessel diameter. We included patients who underwent thrombectomy for MeVO based on the matching strategy (a procedural approach involving vessel diameter assessment, matching aspiration catheter selection, and firm clot engagement with or without a stent retriever). We evaluated efficacy and safety using the modified Thrombolysis in the Cerebral Infarction Scale (mTICI) and intracranial hemorrhage (ICH) and procedure-related complications.ResultsSeventy patients fulfilled the final inclusion criteria. The median occluded vessel diameter was 1.71 mm. We achieved mTICI 2b/2c/3 in 82.9% and mTICI 2c/3 in 51.4% of the cases and did not observe any symptomatic ICH. We detected asymptomatic subarachnoid hemorrhage (SAH) in 24.3% of the cases, that is, 5.6%, 20.0%, and 45.5% in the vessel diameter groups ≥2.0, 1.5-2.0, and ≤1.5 mm, respectively. The SAH incidence was significantly higher in narrower vessel groups. The occluded vessel diameter and the contact method with clots predicted clinical outcomes.ConclusionsMatching strategy-based thrombectomy yields acceptable efficiency and safety results. In narrower vessels, it is optimal to engage matched aspiration catheters and clots without the assistance of conventional stent retrievers.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"2175-2183"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}