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Maximizing First-Pass Complete Reperfusion with SAVE.

Volker Maus1, Daniel Behme2, Christoph Kabbasch3

  • 1Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany. volker.maus@uk-koeln.de.

Clinical Neuroradiology
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Summary
This summary is machine-generated.

The Stent retriever Assisted Vacuum-locked Extraction (SAVE) technique offers rapid and effective first-pass reperfusion for large vessel occlusions in acute ischemic stroke patients. This combined approach shows promising results for mechanical thrombectomy, improving patient outcomes.

Keywords:
Acute ischemic strokeLarge vessel occlusionMechanical thrombectomySAVE

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Area of Science:

  • Neurology
  • Interventional Radiology
  • Vascular Surgery

Background:

  • Advancements in endovascular techniques have improved the treatment of acute ischemic stroke (AIS) caused by large vessel occlusions (LVO).
  • Mechanical thrombectomy (MT) is a key intervention for LVO, with ongoing development of new techniques.
  • This study evaluates a novel combined aspiration and stent retriever approach for MT.

Purpose of the Study:

  • To assess the efficacy and safety of the Stent retriever Assisted Vacuum-locked Extraction (SAVE) technique for MT in LVO patients.
  • To determine the rate of successful first-pass reperfusion (mTICI 3).
  • To evaluate secondary endpoints including procedure time, embolization, hemorrhage, and clinical outcomes.

Main Methods:

  • Retrospective analysis of 32 consecutive AIS patients undergoing MT with the SAVE technique across 3 stroke centers.
  • Primary endpoint: successful first-pass reperfusion (mTICI 3).
  • Secondary endpoints: number of passes, groin puncture to reperfusion time, embolization to new territories (ENT), symptomatic intracranial hemorrhage (sICH), and modified Rankin Scale (mRS) score at discharge.

Main Results:

  • First-pass mTICI 3 reperfusion achieved in 72% of patients (23/32).
  • 100% successful reperfusion (mTICI ≥ 2b) with a mean of 1.2 attempts.
  • Low rates of ENT (0%) and sICH (1 patient), with 59% achieving favorable mRS (≤ 2) at discharge.

Conclusions:

  • The SAVE technique is a rapid and highly effective method for achieving first-pass complete reperfusion in LVO patients.
  • This combined approach demonstrates significant potential for improving outcomes in mechanical thrombectomy for acute ischemic stroke.
  • Further research may validate SAVE as a standard treatment for LVO.