PROTECT: PRoximal balloon Occlusion TogEther with direCt Thrombus aspiration during stent retriever thrombectomy - evaluation of a double embolic protection approach in endovascular stroke treatment.

Maegerlein, Christian; Mönch, Sebastian; Boeckh-Behrens, Tobias; Lehm, Manuel; Hedderich, Dennis M; Berndt, Maria Teresa; Wunderlich, Silke; Zimmer, Claus; Kaesmacher, Johannes; Friedrich, Benjamin

doi:10.1136/neurintsurg-2017-013558

2018

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Title:: PROTECT: PRoximal balloon Occlusion TogEther with direCt Thrombus aspiration during stent retriever thrombectomy - evaluation of a double embolic protection approach in endovascular stroke treatment.
Document type:: Journal Article
Author(s):: Maegerlein, Christian; Mönch, Sebastian; Boeckh-Behrens, Tobias; Lehm, Manuel; Hedderich, Dennis M; Berndt, Maria Teresa; Wunderlich, Silke; Zimmer, Claus; Kaesmacher, Johannes; Friedrich, Benjamin
Abstract:: Stent retriever-based mechanical thrombectomy (MT) for emergent large vessel occlusions (ELVO) is often complicated by thrombus fragmentation causing distal embolization and embolization to new vascular territories. Well-established embolic protection approaches include proximal flow arrest and distal aspiration techniques during stent retriever maneuvers. Aiming at the reduction of thrombus fragmentation during MT we evaluated a technical approach combining proximal balloon occlusion together with direct thrombus aspiration during MT: the PROTECT technique.We performed a case-control study comparing the PROTECT technique with sole distal aspiration during MT regarding technical and procedural parameters, n=200 patients with ELVO of either the terminus of the internal carotid artery or the proximal middle artery were included.PROTECT resulted in a shorter procedure time (29 vs 40 min; P=0.002), in a higher rate of successful recanalizations (100% vs 78%; P=0.001) and a higher rate of complete reperfusions (70% vs 39%; P<0.001) compared with sole distal aspiration during MT.The PROTECT technique is a promising new approach to significantly reduce thrombus fragmentation and, hence distal embolization during MT. This safe and efficient technique needs to be validated in larger trials to confirm our results.
Journal title abbreviation:: J Neurointerv Surg
Year:: 2018
Journal volume:: 10
Journal issue:: 8
Pages contribution:: 751-755
Language:: eng
Fulltext / DOI:: doi:10.1136/neurintsurg-2017-013558
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/29222393
Print-ISSN:: 1759-8478
TUM Institution:: Fachgebiet Neuroradiologie (Prof. Zimmer); Neurologische Klinik und Poliklinik
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