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Another Endovascular Therapy Strategy for Acute Tandem Occlusion: Protect-Expand-Aspiration-Revascularization-Stent (PEARS) Technique. | LitMetric

AI Article Synopsis

  • - The study investigates the effectiveness of a "half" anterograde approach for treating acute ischemic strokes caused by stenotic occlusion of the internal carotid artery and examines the outcomes of two variations of this technique: one using the PEARS method and one without it.
  • - Data from 26 patients showed a high recanalization success rate of 96.3%, with 61.8% achieving a good clinical outcome, although there were some complications such as hemorrhage (7.7%) and mortality (15.4%).
  • - The PEARS technique was found to be superior, resulting in significantly shorter procedure times and fewer embolic events compared to the plain technique, suggesting that it should be preferred for

Article Abstract

Objective: Initial stenotic occlusion of the internal carotid artery with intracranial artery occlusion in acute ischemic stroke is associated with high morbidity and can benefit from endovascular therapy. However, the optimal endovascular strategy is unclear. This study aimed to evaluate the feasibility of the "half" anterograde approach and clinical outcome of treated patients. Revascularization validity of the 2 "half" anterograde approach with (Protect-Expand-Aspiration-Revascularization-Stent [PEARS] technique) or without (plain technique) using an embolic prevention device and aspiration was also compared.

Methods: Data on initial stenotic occlusion of the internal carotid artery with intracranial artery occlusion in our prospective stroke registry database between January 2015 and February 2017 were collected. Clinical and angiographic data were retrospectively analyzed. Clinical outcome was evaluated at 3 months, defined as a modified Rankin scale ≤2 as a good clinical outcome.

Results: Overall, 26 patients with tandem occlusion were included; 96.3% of patients had successful recanalization. The rate of a good clinical outcome was 61.8%, symptomatic parenchymal hemorrhage was 7.7%, and mortality was 15.4%. The PEARS technique took less time (56 ± 14 vs. 97 ± 31 minutes; P = 0.002) and had less embolic events (0 vs. 30.8%; P = 0.012) compared with the plain technique. Use of the PEARS technique was an independent predictor for shortening revascularization time (β = -0.651, P = 0.001).

Conclusions: The half anterograde approach technique is feasible and safe for treating tandem occlusion. Furthermore, the PEARS technique is associated with a shorter reperfusion time and less embolic events than the plain technique, and should be recommended in tandem occlusion.

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Source
http://dx.doi.org/10.1016/j.wneu.2018.02.052DOI Listing

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