Use of the pRESET LITE thrombectomy device in combined approach for medium vessel occlusions: A multicenter evaluation

Maud Wang¹, Hans Henkes², Sherief Ghozy³, James E Siegler⁴, Hamza Shaikh⁴, Jane Khalife⁴, Mohamad Abdalkader⁵, Piers Klein⁵, Thanh N Nguyen⁵, Jeremy J Heit⁶, Ahmad Sweid³, Kareem El Naamani⁷, Robert W Regenhardt⁸, Jose Danilo Bengzon Diestro⁹, Nicole M Cancelliere⁹, Abdelaziz Amllay⁷, Lukas Meyer¹⁰, Anne Dusart¹¹, Flavio Bellante¹¹, Géraud Forestier¹², Aymeric Rouchaud¹², Suzana Saleme¹², Charbel Mounayer¹², Jens Fiehler¹⁰, Anna Luisa Kühn¹³, Ajit S Puri¹³, Christian Dyzmann¹⁴, Peter T Kan¹⁵, Marco Colasurdo¹⁵, Gaultier Marnat¹⁶, Jérôme Berge¹⁶, Xavier Barreau¹⁶, Igor Sibon¹⁷, Simona Nedelcu¹⁸, Nils Henninger^{18

19}, Charlotte Weyland²⁰, Thomas R Marotta⁹, Christopher J Stapleton⁸, James D Rabinov⁸, Takahiro Ota²¹, Shogo Dofuku²¹, Leonard Ll Yeo²², Benjamin Y Q Tan^{22

23}, Juan Carlos Martinez-Gutierrez²⁴, Sergio Salazar-Marioni²⁴, Sunil Sheth²⁴, Leonardo Renieri²⁵, Carolina Capirossi²⁵, Ashkan Mowla²⁶, Stavropoula I Tjoumakaris⁷, Pascal Jabbour⁷, Priyank Khandelwal²⁷, Arundhati Biswas²⁸, Frédéric Clarençon²⁹, Mahmoud Elhorany^{29

30}, Kevin Premat²⁹, Iacopo Valente³¹, Alessandro Pedicelli³¹, João Pedro Filipe³², Ricardo Varela³³, Miguel Quintero-Consuegra³⁴, Nestor R Gonzalez³⁴, Markus A Möhlenbruch³⁵, Jessica Jesser³⁵, Vincent Costalat³⁶, Adrien Ter Schiphorst³⁷, Vivek Yedavalli³⁸, Pablo Harker³⁹, Lina M Chervak³⁹, Yasmin Aziz³⁹, Benjamin Gory⁴⁰, Christian Paul Stracke⁴¹, Constantin Hecker⁴², Monika Killer-Oberpfalzer⁴², Christoph J Griessenauer⁴², Ajith J Thomas⁴, Cheng-Yang Hsieh⁴³, David S Liebeskind⁴⁴, Răzvan Alexandru Radu³⁶, Andrea M Alexandre³¹, Illario Tancredi⁴⁵, Tobias D Faizy¹⁰, Aman B Patel⁸, Vitor Mendes Pereira⁹, Robert Fahed⁴⁶, Boris Lubicz⁴⁷, Adam A Dmytriw^{8

9}, Adrien Guenego⁴⁷; M.A.D.-M.T. Consortium

Affiliations

¹ Department of Radiology, Leuven University Hospitals, Leuven, Belgium. wang.maud@gmail.com.
² Neuroradiologische Klinik, Klinikum Stuttgart, Stuttgart, Germany.
³ Departments of Neurologic Surgery & Radiology, Mayo Clinic, Rochester, MN, USA.
⁴ Cooper Neurological Institute, Cooper University Hospital, Cooper Medical School of Rowen University, Camden, NJ, USA.
⁵ Departments of Radiology & Neurology, Boston Medical Center, Boston, MA, USA.
⁶ Department of Interventional Neuroradiology, Stanford Medical Center, Palo Alto, CA, USA.
⁷ Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA.
⁸ Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA.
⁹ Neurovascular Centre, Departments of Medical Imaging and Neurosurgery, St. Michael's Hospital, Toronto, ON, Canada.
¹⁰ Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
¹¹ Department of Neurology, Hôpital Civil Marie Curie, Charleroi, Belgium.
¹² Department of Neuroradiology, CHU Limoges Dupuytren, Université de Limoges, Limoges, France.
¹³ Department of Radiology, University of Massachusetts Memorial Hospital, Worcester, MA, USA.
¹⁴ Department of Neuroradiology, Sana Kliniken, Lübeck GmbH, Lübeck, Germany.
¹⁵ Department of Neurosurgery, University of Texas Medical Branch, Galveston, TX, USA.
¹⁶ Department of Interventional Neuroradiology, CHU Bordeaux, Bordeaux, France.
¹⁷ Department of Neurology, CHU Bordeaux, Bordeaux, France.
¹⁸ Department of Neurology, University of Massachusetts Chan Medical School, Worcester, MA, USA.
¹⁹ Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, MA, USA.
²⁰ Department of Neuroradiology, University Hospital RWTH Aachen, Aachen, Germany.
²¹ Department of Neurosurgery, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan.
²² Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
²³ Division of Neurology, Department of Medicine, National University Hospital, Singapore, Singapore.
²⁴ Department of Neurology, UTHealth McGovern Medical School, Houston, TX, USA.
²⁵ Interventistica Neurovascolare, Ospedale Careggi Di Firenze, Florence, Italy.
²⁶ Division of Stroke and Endovascular Neurosurgery, Department of Neurological Surgery, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA.
²⁷ Department of Endovascular Neurosurgery and Neuroradiology NJMS, Newark, NJ, USA.
²⁸ Department of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, NY, USA.
²⁹ Department of Neuroradiology, Pitié-Salpêtrière University Hospitals, Sorbonne University- Paris VI, Paris, France.
³⁰ Department of Neurology, Faculty of Medicine, Tanta University, Tanta, Egypt.
³¹ UOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
³² Department of Diagnostic and Interventional Neuroradiology, Centro Hospitalar Universitário Do Porto, Porto, Portugal.
³³ Department of Neurology, Centro Hospitalar Universitário Do Porto, Porto, Portugal.
³⁴ Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
³⁵ Sektion Vaskuläre Und Interventionelle Neuroradiologie, Universitätsklinikum Heidelberg, Heidelberg, Germany.
³⁶ Department of Neuroradiology, Gui de Chauliac Hospital, CHU Montpellier, Montpellier, France.
³⁷ Department of Neurology, Gui de Chauliac Hospital, CHU Montpellier, Montpellier, France.
³⁸ Department of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, MD, USA.
³⁹ Department of Neurology, University of Cincinnati Medical Center, Cincinnati, OH, USA.
⁴⁰ Department of Interventional Neuroradiology, CHU Nancy, Nancy, France.
⁴¹ Department of Radiology, Interventional Neuroradiology Section, University Medical Center Münster, Münster, Germany.
⁴² Departments of Neurology & Neurosurgery, Christian Doppler Clinic, Paracelsus Medical University Salzburg, Salzburg, Austria.
⁴³ Neurology Department, Sin-Lau Hospital, Tainan, Taiwan.
⁴⁴ Department of Neurology Department, UCLA Stroke Center, UCLA, Los Angeles, CA, USA.
⁴⁵ Department of Radiology, Hôpital Civil Marie Curie, Charleroi, Belgium.
⁴⁶ Department of Medicine, Division of Neurology, The Ottawa Hospital, Ottawa Hospital Research Institute and University of Ottawa, Ottawa, ON, Canada.
⁴⁷ Department of Interventional Neuroradiology, Erasme University Hospital, Brussels, Belgium.

PMID: 38381145
DOI: 10.1007/s00234-024-03302-5

Review

Use of the pRESET LITE thrombectomy device in combined approach for medium vessel occlusions: A multicenter evaluation

Maud Wang et al. Neuroradiology. 2024 Apr.

. 2024 Apr;66(4):631-641.

doi: 10.1007/s00234-024-03302-5. Epub 2024 Feb 21.

Authors

Affiliations

¹ Department of Radiology, Leuven University Hospitals, Leuven, Belgium. wang.maud@gmail.com.
² Neuroradiologische Klinik, Klinikum Stuttgart, Stuttgart, Germany.
³ Departments of Neurologic Surgery & Radiology, Mayo Clinic, Rochester, MN, USA.
⁴ Cooper Neurological Institute, Cooper University Hospital, Cooper Medical School of Rowen University, Camden, NJ, USA.
⁵ Departments of Radiology & Neurology, Boston Medical Center, Boston, MA, USA.
⁶ Department of Interventional Neuroradiology, Stanford Medical Center, Palo Alto, CA, USA.
⁷ Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA.
⁸ Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA.
⁹ Neurovascular Centre, Departments of Medical Imaging and Neurosurgery, St. Michael's Hospital, Toronto, ON, Canada.
¹⁰ Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
¹¹ Department of Neurology, Hôpital Civil Marie Curie, Charleroi, Belgium.
¹² Department of Neuroradiology, CHU Limoges Dupuytren, Université de Limoges, Limoges, France.
¹³ Department of Radiology, University of Massachusetts Memorial Hospital, Worcester, MA, USA.
¹⁴ Department of Neuroradiology, Sana Kliniken, Lübeck GmbH, Lübeck, Germany.
¹⁵ Department of Neurosurgery, University of Texas Medical Branch, Galveston, TX, USA.
¹⁶ Department of Interventional Neuroradiology, CHU Bordeaux, Bordeaux, France.
¹⁷ Department of Neurology, CHU Bordeaux, Bordeaux, France.
¹⁸ Department of Neurology, University of Massachusetts Chan Medical School, Worcester, MA, USA.
¹⁹ Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, MA, USA.
²⁰ Department of Neuroradiology, University Hospital RWTH Aachen, Aachen, Germany.
²¹ Department of Neurosurgery, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan.
²² Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
²³ Division of Neurology, Department of Medicine, National University Hospital, Singapore, Singapore.
²⁴ Department of Neurology, UTHealth McGovern Medical School, Houston, TX, USA.
²⁵ Interventistica Neurovascolare, Ospedale Careggi Di Firenze, Florence, Italy.
²⁶ Division of Stroke and Endovascular Neurosurgery, Department of Neurological Surgery, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA.
²⁷ Department of Endovascular Neurosurgery and Neuroradiology NJMS, Newark, NJ, USA.
²⁸ Department of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, NY, USA.
²⁹ Department of Neuroradiology, Pitié-Salpêtrière University Hospitals, Sorbonne University- Paris VI, Paris, France.
³⁰ Department of Neurology, Faculty of Medicine, Tanta University, Tanta, Egypt.
³¹ UOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
³² Department of Diagnostic and Interventional Neuroradiology, Centro Hospitalar Universitário Do Porto, Porto, Portugal.
³³ Department of Neurology, Centro Hospitalar Universitário Do Porto, Porto, Portugal.
³⁴ Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
³⁵ Sektion Vaskuläre Und Interventionelle Neuroradiologie, Universitätsklinikum Heidelberg, Heidelberg, Germany.
³⁶ Department of Neuroradiology, Gui de Chauliac Hospital, CHU Montpellier, Montpellier, France.
³⁷ Department of Neurology, Gui de Chauliac Hospital, CHU Montpellier, Montpellier, France.
³⁸ Department of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, MD, USA.
³⁹ Department of Neurology, University of Cincinnati Medical Center, Cincinnati, OH, USA.
⁴⁰ Department of Interventional Neuroradiology, CHU Nancy, Nancy, France.
⁴¹ Department of Radiology, Interventional Neuroradiology Section, University Medical Center Münster, Münster, Germany.
⁴² Departments of Neurology & Neurosurgery, Christian Doppler Clinic, Paracelsus Medical University Salzburg, Salzburg, Austria.
⁴³ Neurology Department, Sin-Lau Hospital, Tainan, Taiwan.
⁴⁴ Department of Neurology Department, UCLA Stroke Center, UCLA, Los Angeles, CA, USA.
⁴⁵ Department of Radiology, Hôpital Civil Marie Curie, Charleroi, Belgium.
⁴⁶ Department of Medicine, Division of Neurology, The Ottawa Hospital, Ottawa Hospital Research Institute and University of Ottawa, Ottawa, ON, Canada.
⁴⁷ Department of Interventional Neuroradiology, Erasme University Hospital, Brussels, Belgium.

PMID: 38381145
DOI: 10.1007/s00234-024-03302-5

Abstract

Purpose: Our purpose was to assess the efficacy and safety of the pRESET LITE stent retriever (Phenox, Bochum, Germany), designed for medium vessel occlusion (MeVO) in acute ischemic stroke (AIS) patients with a primary MeVO.

Methods: We performed a retrospective analysis of the MAD MT Consortium, an integration of prospectively maintained databases at 37 academic institutions in Europe, North America, and Asia, of AIS patients who underwent mechanical thrombectomy with the pRESET LITE stent retriever for a primary MeVO. We subcategorized occlusions into proximal MeVOs (segments A1, M2, and P1) vs. distal MeVOs/DMVO (segments A2, M3-M4, and P2). We reviewed patient and procedural characteristics, as well as angiographic and clinical outcomes.

Results: Between September 2016 and December 2021, 227 patients were included (50% female, median age 78 [65-84] years), of whom 161 (71%) suffered proximal MeVO and 66 (29%) distal MeVO. Using a combined approach in 96% of cases, successful reperfusion of the target vessel (mTICI 2b/2c/3) was attained in 85% of proximal MeVO and 97% of DMVO, with a median of 2 passes (IQR: 1-3) overall. Periprocedural complications rate was 7%. Control CT at day 1 post-MT revealed a hemorrhagic transformation in 63 (39%) patients with proximal MeVO and 24 (36%) patients with DMVO, with ECASS-PH type hemorrhagic transformations occurring in 3 (1%) patients. After 3 months, 58% of all MeVO and 63% of DMVO patients demonstrated a favorable outcome (mRS 0-2).

Conclusion: Mechanical thrombectomy using the pRESET LITE in a combined approach with an aspiration catheter appears effective for primary medium vessel occlusions across several centers and physicians.

Keywords: Distal thrombectomy; Endovascular recanalization; Medium vessel occlusion; Stent retriever; Stroke.

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References

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Use of the pRESET LITE thrombectomy device in combined approach for medium vessel occlusions: A multicenter evaluation

Affiliations

Use of the pRESET LITE thrombectomy device in combined approach for medium vessel occlusions: A multicenter evaluation

Authors

Affiliations

Abstract

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical