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@article{1834320,
author = {Kashani, N. and Cimflová, Petra and Ospel, J. M. and Singh, N. and Almekhlafi, M. A. and Rempel, J. and Fiehler, J. and Chen, M. and Sakai, N. and Agid, R. and Heran, M. and Kappelhof, M. and Goyal, M.},
article_location = {Lausanne},
article_number = {September 2021},
doi = {http://dx.doi.org/10.3389/fneur.2021.735899},
keywords = {acute ischemic stroke; endovascular thrombectomy; aspiration thrombectomy; medium vessel occlusions; endovascular treatment (EVT); MeVO; stroke; neurointervention},
language = {eng},
issn = {1664-2295},
journal = {Frontiers in Neurology},
title = {Endovascular Device Choice and Tools for Recanalization of Medium Vessel Occlusions: Insights From the MeVO FRONTIERS International Survey},
url = {https://www.frontiersin.org/articles/10.3389/fneur.2021.735899/full},
volume = {12},
year = {2021}
}
TY - JOUR
ID - 1834320
AU - Kashani, N. - Cimflová, Petra - Ospel, J. M. - Singh, N. - Almekhlafi, M. A. - Rempel, J. - Fiehler, J. - Chen, M. - Sakai, N. - Agid, R. - Heran, M. - Kappelhof, M. - Goyal, M.
PY - 2021
TI - Endovascular Device Choice and Tools for Recanalization of Medium Vessel Occlusions: Insights From the MeVO FRONTIERS International Survey
JF - Frontiers in Neurology
VL - 12
IS - September 2021
SP - 1-7
EP - 1-7
PB - Frontiers
SN - 16642295
KW - acute ischemic stroke
KW - endovascular thrombectomy
KW - aspiration thrombectomy
KW - medium vessel occlusions
KW - endovascular treatment (EVT)
KW - MeVO
KW - stroke
KW - neurointervention
UR - https://www.frontiersin.org/articles/10.3389/fneur.2021.735899/full
N2 - Background: Endovascular treatment (EVT) for stroke due to medium vessel occlusion (MeVO) can be technically challenging. Devices and tools are rapidly evolving. We aimed to gain insight into preferences and global perspectives on the usage of endovascular tools in treating MeVOs. Methods: We conducted an international survey with seven scenarios of patients presenting A3, M2/3, M3, M3/4, or P2/3 occlusions. Respondents were asked for their preferred first-line endovascular approach, and whether they felt that the appropriate endovascular tools were available to them. Answers were analyzed by occlusion location and geographical region of practice, using multinomial/binary logistic regression. Results: A total of 263 neurointerventionists provided 1836 responses. The first-line preferences of physicians were evenly distributed among stent-retrievers, combined approaches, and aspiration only (33.2, 29.8, and 26.8%, respectively). A3 occlusions were more often treated with stent-retrievers (RR 1.21, 95% CI: 1.07-1.36), while intra-arterial thrombolysis was more often preferred in M3 (RR 2.47, 95% CI: 1.53-3.98) and M3/4 occlusions (RR 7.71, 95% CI: 4.16-14.28) compared to M2/3 occlusions. Respondents who thought appropriate tools are currently not available more often chose stent retrievers alone (RR 2.07; 95% CI: 1.01-4.24) or intra-arterial thrombolysis (RR 3.35, 95% CI: 1.26-8.42). Physicians who stated that they do not have access to optimal tools opted more often not to treat at all (RR 3.41, 95% CI: 1.11-10.49). Stent-retrievers alone were chosen more often and contact aspiration alone less often as a first-line approach in Europe (RR 2.12, 95% CI: 1.38-3.24; and RR 0.49, 95% CI 0.34-0.70, respectively) compared to the United States and Canada. Conclusions: In EVT for MeVO strokes, neurointerventionalists choose a targeted vessel specific first-line approach depending on the occlusion location, region of practice, and availability of the appropriate tools.
ER -
KASHANI, N., Petra CIMFLOVÁ, J. M. OSPEL, N. SINGH, M. A. ALMEKHLAFI, J. REMPEL, J. FIEHLER, M. CHEN, N. SAKAI, R. AGID, M. HERAN, M. KAPPELHOF a M. GOYAL. Endovascular Device Choice and Tools for Recanalization of Medium Vessel Occlusions: Insights From the MeVO FRONTIERS International Survey. \textit{Frontiers in Neurology}. Lausanne: Frontiers, 2021, roč.~12, September 2021, s.~1-7. ISSN~1664-2295. Dostupné z: https://dx.doi.org/10.3389/fneur.2021.735899.
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