Related Experiment Video
Updated: Jan 14, 2026
Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
Shorter procedures and less radiation with monopoint aspiration compared to conventional aspiration or
Joey D English1,2, Fabio Settecase1,2, Jaehyun Kim1,2
1Neurointerventional Surgery, California Pacific Medical Center, San Francisco, CA, USA.
Abstract:
IntroductionMechanical thrombectomy (MT) techniques affect procedure lengths and radiation exposure, with both reduced with contact aspiration (CA) compared to combination stentriever-assisted aspiration (SA). Monopoint MT has higher first pass effect (FPE) rates, less technical crossover, and recanalization with fewer passes. Monopoint MT may thus be associated with shorter procedural times and less radiation.Materials/MethodsAnterior circulation large vessel MT cases across four centers were identified, assigning cases to Monopoint, CA, or SA groups based on the first-line technique employed, excluding cases that could not be assigned to one of these three groups. Clinical variables, technical details, times to first and final pass, fluoroscopy time, dose-area product (DAP), and radiation dose were recorded. Univariable and multivariable analyses were performed to compare procedural times and radiation data among treatment groups.ResultsSeventy-seven Monopoint, 32 CA, 42 SA cases were analyzed. Time to first pass was shortest with Monopoint (p < 0.001), as was time to final pass (p < 0.001). There was no significant difference in fluoroscopy time between Monopoint (17.7 min) and CA (17.6, p = 0.835); both were lower than SA (26.4, p < 0.001). DAP was lowest for Monopoint (18,854 µGy*m2) compared to CA (31,325) and SA (29,483, p < 0.001). Radiation dose was lowest with Monopoint (884 mGy) compared to CA (1095) and SA (1994, p < 0.001).ConclusionMT for anterior circulation large vessel occlusions had shorter procedural times and involved less radiation with Monopoint compared to CA and SA. Further investigation is warranted to assess other clinical and technical factors that affect procedure duration, DAP, and radiation dose.
Insights
Monopoint mechanical thrombectomy (MT) significantly reduces procedure times and radiation exposure compared to contact aspiration (CA) and stent retriever-assisted aspiration (SA) for large vessel occlusions. This technique offers a safer and more efficient approach for stroke treatment.
Area of Science:
- Endovascular therapy
- Neurointerventional radiology
- Stroke treatment
Background:
- Mechanical thrombectomy (MT) techniques influence procedure duration and radiation exposure.
- Contact aspiration (CA) and stent retriever-assisted aspiration (SA) are established MT methods.
- Monopoint MT shows potential for improved efficiency and reduced radiation.
Purpose of the Study:
- To compare procedural times and radiation exposure among Monopoint MT, CA, and SA techniques.
- To evaluate the efficacy of Monopoint MT in anterior circulation large vessel occlusions.
- To identify factors influencing procedure duration and radiation dose in MT.
Main Methods:
- Retrospective analysis of 151 anterior circulation large vessel MT cases across four centers.
- Cases were categorized into Monopoint, CA, or SA groups based on the initial technique.
- Data collected included clinical variables, technical details, pass times, fluoroscopy time, dose-area product (DAP), and radiation dose.
Main Results:
- Monopoint MT demonstrated the shortest time to first and final pass.
- Fluoroscopy time was similar for Monopoint and CA, but lower than SA.
- Monopoint MT resulted in significantly lower DAP and radiation dose compared to CA and SA.
Conclusions:
- Monopoint MT is associated with shorter procedural times and reduced radiation exposure for anterior circulation large vessel occlusions compared to CA and SA.
- Further research is needed to explore other clinical and technical factors impacting MT outcomes.
