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 and M. GOYAL. Endovascular Device Choice and Tools for Recanalization of Medium Vessel Occlusions: Insights From the MeVO FRONTIERS International Survey. Frontiers in Neurology. Lausanne: Frontiers, 2021, vol. 12, September 2021, p. 1-7. ISSN 1664-2295. Available from: https://dx.doi.org/10.3389/fneur.2021.735899.
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Basic information
Original name Endovascular Device Choice and Tools for Recanalization of Medium Vessel Occlusions: Insights From the MeVO FRONTIERS International Survey
Authors KASHANI, N., Petra CIMFLOVÁ (203 Czech Republic, belonging to the institution), J. M. OSPEL, N. SINGH, M. A. ALMEKHLAFI, J. REMPEL, J. FIEHLER, M. CHEN, N. SAKAI, R. AGID, M. HERAN, M. KAPPELHOF and M. GOYAL (guarantor).
Edition Frontiers in Neurology, Lausanne, Frontiers, 2021, 1664-2295.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30210 Clinical neurology
Country of publisher Switzerland
Confidentiality degree is not subject to a state or trade secret
WWW URL
Impact factor Impact factor: 4.086
RIV identification code RIV/00216224:14110/21:00124157
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.3389/fneur.2021.735899
UT WoS 000701296000001
Keywords in English acute ischemic stroke; endovascular thrombectomy; aspiration thrombectomy; medium vessel occlusions; endovascular treatment (EVT); MeVO; stroke; neurointervention
Tags 14110119, rivok
Tags International impact, Reviewed
Changed by Changed by: Mgr. Tereza Miškechová, učo 341652. Changed: 15/2/2022 10:30.
Abstract
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.
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