JAMA: Combined thrombectomy vs simple stent recovery, which is more beneficial for large vessel occlusive stroke

Intracranial atherosclerosis (ICAS) is an acute ischemic cerebral stroke one (AIS) is a major cause
.

Although the current mainstream intravenous thrombolytic therapy has good curative effect, its recanalization rate is low and therisk of vascular reocclusion is high

Intracranial atherosclerosis (ICAS) is an acute ischemic cerebral stroke one (AIS) is a major cause

thrombus

In order to determine whether the mechanical thrombectomy has a better final angiography result than the standard stent extractor alone, compared to the standard stent extractor alone, the mechanical thrombectomy is used to treat strokes with occlusion of the circulation and great blood vessels
.

Experts from the Department of Neurology of the University of Versailles in France carried out relevant research and the results were published in the JAMA journal

JAMA

This trial is a multicenter randomized, open-label, blinded endpoint evaluation.
From October 16, 2017 to May 29, 2018, 408 patients were recruited from 11 comprehensive stroke centers in France and lasted for 12 months.
Result tracking
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Patients with anterior circulation and great vessel occlusion were included within 8 hours after the onset of symptoms and were followed up until June 19, 2019

Patients were randomly assigned (1:1 allocation) to receive initial thrombectomy combined with contact aspiration and stent retriever (205) or a separate stent retriever (203)
.

The main result is the rate of cerebral infarction thrombolysis score reaching 2c or 3 points (eTICI 2c/3; that is, the score indicates the level of close to complete and complete reperfusion) at the end of the operation

Of the 408 randomized patients, 3 were excluded, and 405 (99.
3%) patients (mean age 73 years; 220 [54%] women and 185 [46%] men) were included in the main analysis
.

There was no significant difference in the ratio of eTICI 2c/3 at the end of endovascular surgery between the two thrombectomy groups (64.

There was no significant difference in the ratio of eTICI 2c/3 at the end of endovascular surgery between the two thrombectomy groups (64.

Differences in the primary efficacy endpoints between the two groups

Of the 14 pre-specified secondary efficacy endpoints, 12 showed no significant differences
.

The contact aspiration combined stent recovery group had a higher success rate of reperfusion compared with the stent recovery group alone (eTICI 2b50/2c/3, 86.

The contact aspiration combined stent recovery group had a higher success rate of reperfusion compared with the stent recovery group alone (eTICI 2b50/2c/3, 86.

In patients with acute ischemic stroke caused by large vessel occlusion, the initial thrombectomy technique consisting of a combination of contact aspiration and stent retractor does not significantly improve the approach to the end of endovascular surgery compared with the stent retractor alone Complete or complete reperfusion rate (eTICI 2c/3)

references:

Effect of Thrombectomy With Combined Contact Aspiration and Stent Retriever vs Stent Retriever Alone on Revascularization in Patients With Acute Ischemic Stroke and Large Vessel Occlusion: The ASTER2 Randomized Clinical Trial.
JAMA.
2021;326(12):1158–1169.
doi:10.
1001/ jama.
2021.
13827

Effect of Thrombectomy With Combined Contact Aspiration and Stent Retriever vs Stent Retriever Alone on Revascularization in Patients With Acute Ischemic Stroke and Large Vessel Occlusion: The ASTER2 Randomized Clinical Trial.
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