Optimización de la recanalización arterial en el tratamiento endovascular del ictus isquémico agudo

Abstract

Endovascular treatment (EVT) +/- intravenous fibrinolysis is the treatment of choice in patients with acute ischemic stroke and large vessel occlusion. Recently, new EVT techniques have been developed, including the combination of stent-retriever (SR) and contact aspiration (CA), however, there is still a percentage of patients where vascular reperfusion is not achieved. There are devices that allow combined EVT (SR+CA) in large vessel occlusion and medium vessel occlusion and rescue techniques after failed EVT, however, it is not yet defined which technique is the most effective in the different segments of the cerebral vascular tree. The aim is to analyze the effectiveness and safety of combined EVT in large vessel occlusion, M2 segment of middle cerebral artery (MCA) and medium vessel occlusions and of rescue stent deployment after EVT failure, through a compendium of publications. Article 1 corresponds to a retrospective analysis of patients with large vessel occlusion and treated with SR+CA using different bore aspiration catheters between 2018 and 2020 at two centers, comparing procedural and clinical outcomes between groups. 238 patients with large vessel occlusion were treated with SR+CA during the study period and the use of the larger-bore aspiration catheter was associated with a higher first-pass effect rate, shorter procedure times and lower complication rate...