Thrombectomy Using "Clamping Embolus with Semi-Retrieval" Technique in Acute Ischemic Stroke

Area of Science:

• Neurology
• Interventional Neuroradiology
• Cardiovascular Interventions

Background:

• Neurothrombectomy for acute ischemic stroke carries a risk of embolization.
• Embolization can necessitate repeat thrombectomy procedures, increasing procedural complexity and risk.
• The Thrombectomy with Clamping Embolus Technique (TCET) was developed to mitigate these risks.

Purpose of the Study:

• To describe the technical outcomes of the TCET method in acute ischemic stroke.
• To evaluate the efficiency of mechanical thrombectomy using TCET.
• To compare TCET with conventional stent retriever thrombectomy (CSRT).

Main Methods:

• Retrospective analysis of 52 patients with intracranial large vessel occlusion.
• Comparison of recanalization rates, procedure duration, and thrombectomy attempts between TCET and CSRT groups.
• Patients underwent either TCET or CSRT between January 2015 and October 2016.

Main Results:

• Recanalization rates (TICI 2b or 3) were similar between TCET (91.7%) and CSRT (92.9%).
• TCET significantly reduced the number of thrombectomy attempts in embolic cases (1.7 vs. 2.6, P=.001).
• TCET demonstrated a significantly higher one-pass thrombectomy rate (58.8% vs. 25.0%, P=.014) and shorter procedure duration (35.8 vs. 55.5 minutes, P=.001) compared to CSRT.

Conclusions:

• TCET is a safe and effective technique for mechanical thrombectomy in acute ischemic stroke.
• TCET shows improved efficiency over CSRT, evidenced by fewer attempts and shorter procedure times.
• TCET may represent an advancement in neurothrombectomy, potentially improving patient outcomes.