ARTS (Aspiration-Retriever Technique for Stroke): Initial clinical experience

Francesco Massari, Nils Henninger, Juan Diego Lozano, Anand Patel, Anna Luisa Kuhn, Mary Howk, Mary Perras, Christopher Brooks, Matthew J. Gounis, Peter Kan, Ajay K. Wakhloo, Ajit S. Puri

Research output: Contribution to journalArticle

55 Scopus citations

Abstract

Background A new generation of highly navigable large-bore aspiration catheters and retriever devices for intracranial mechanical thrombectomy has markedly improved recanalization rates, time and clinical outcomes. We report collected clinical data utilizing a new technique based on combined large lumen aspiration catheter and partially resheathed stent retriever (ARTS: Aspiration (catheter)-(stent) Retriever Technique for Stroke). This technique is applied, especially in presence of bulky/rubbery emboli, when resistance is felt while retracting the stent retriever; at that point the entire assembly is locked and removed in-toto under continuous aspiration with additional flow arrest. Methods A retrospective data analysis was performed to identify patients with large cerebral artery acute ischemic stroke treated with ARTS. The study was conducted between August 2013 and February 2015 at a single high volume stroke center. Procedural and clinical data were captured for analysis. Results Forty-two patients (median age 66 years) met inclusion criteria for this study. The ARTS was successful in achieving Thrombolysis in Cerebral Infarction (TICI) ≥2b revascularization in 97.6% of cases (TICI 2b = 18 patients, TICI 3 = 23 patients). Patients' median National Institutes of Health Stroke Scale score at admission was 18 (6-40). A 3-month follow-up modified Rankin Scale value of 0-2 was achieved in 65.7% of the successfully treated patients (average 2.4). Two patients (4.8%) developed symptomatic intraparenchymal hemorrhages. Six procedure unrelated deaths were observed. Conclusions We found that ARTS is a fast, safe and effective method for endovascular recanalization of large vessel occlusions presenting within the context of acute ischemic stroke.

Original languageEnglish (US)
Pages (from-to)325-332
Number of pages8
JournalInterventional Neuroradiology
Volume22
Issue number3
DOIs
StatePublished - 2016

Keywords

  • Stroke
  • TICI
  • aspiration catheter
  • mechanical thrombectomy
  • stent retriever

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

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    Massari, F., Henninger, N., Lozano, J. D., Patel, A., Kuhn, A. L., Howk, M., Perras, M., Brooks, C., Gounis, M. J., Kan, P., Wakhloo, A. K., & Puri, A. S. (2016). ARTS (Aspiration-Retriever Technique for Stroke): Initial clinical experience. Interventional Neuroradiology, 22(3), 325-332. https://doi.org/10.1177/1591019916632369