TY - JOUR AU - Gadow, Niels von AU - Nikoubashman, Omid AU - Freiherr, Jessica AU - Block, Frank AU - Reich, Arno AU - Fesl, Gunther AU - Wiesmann, Martin PY - 2017 TI - Endovascular stroke treatment now and then—procedural and clinical effectiveness and safety of different mechanical thrombectomy techniques over time JF - Quantitative Imaging in Medicine and Surgery; Vol 7, No 1 (February 28, 2017): Quantitative Imaging in Medicine and Surgery Y2 - 2017 KW - N2 - Background: The most essential development in endovascular stroke treatment (EST) was the shift from intra-arterial thrombolysis to endovascular thrombectomy with dedicated thrombectomy devices, most notably the introduction of stent-retrievers. We evaluated procedural and clinical effectiveness and safety of different EST techniques over time. Methods: We retrospectively analyzed EST cases that were treated by the same interventionalist before (n=36) and after (n=50) stent-retrievers were established as the treatment device of first choice. EST techniques in the first cohort comprised intra-arterial thrombolysis (n=24), manual thrombus aspiration (n=15), the use of the Penumbra thrombectomy system (n=13) and the Phenox clot retriever (n=3), intracranial stenting (n=10), and EST with stent-retrievers as a salvage procedure (n=11). In the second cohort, EST with stent-retrievers was the treatment option of first choice (n=47). Intra-arterial thrombolysis (n=15) and stenting of the occluded vessel (n=1) were performed, whenever EST with stent-retrievers failed. Results: In both cohorts, revascularization rates (TICI ≥2b) were high (91.7% and 86.0%, respectively). A significantly lower number of interventional techniques per case were required in the second cohort (mean ± SD, 1.4±0.5 vs . 2.1±0.9, P vs . 163 minutes on average, P vs . 22.2%, P=0.083). Conclusions: Our findings imply that when stent-retrievers were established as first-line the treatment device a significantly lower number of interventional techniques per case were required and recanalization was achieved almost twice as fast. UR - https://qims.amegroups.org/article/view/13782