Use of the Preset LITE Thrombectomy Device in Combined Approach for Medium Vessel Occlusions: A Multicenter Evaluation

Authors

Maud Wang, Department of Radiology, Leuven University Hospitals, Leuven, Belgium. wang.maud@gmail.com.
Hans Henkes, Neuroradiologische Klinik, Klinikum Stuttgart, Stuttgart, Germany.
Sherief Ghozy, Departments of Neurologic Surgery & Radiology, Mayo Clinic, Rochester, MN, USA.
James E. Siegler, Cooper Neurological Institute, Cooper University Hospital, Cooper Medical School of Rowen University, Camden, NJ, USA.
Hamza Shaikh, Cooper Neurological Institute, Cooper University Hospital, Cooper Medical School of Rowen University, Camden, NJ, USA.
Jane Khalife, Cooper Neurological Institute, Cooper University Hospital, Cooper Medical School of Rowen University, Camden, NJ, USA.
Mohamad Abdalkader, Departments of Radiology & Neurology, Boston Medical Center, Boston, MA, USA.
Piers Klein, Departments of Radiology & Neurology, Boston Medical Center, Boston, MA, USA.
Thanh N. Nguyen, Departments of Radiology & Neurology, Boston Medical Center, Boston, MA, USA.
Jeremy J. Heit, Department of Interventional Neuroradiology, Stanford Medical Center, Palo Alto, CA, USA.
Ahmad Sweid, Departments of Neurologic Surgery & Radiology, Mayo Clinic, Rochester, MN, USA.
Kareem El Naamani, Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA.
Robert W. Regenhardt, Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA.
Jose Danilo Diestro, Neurovascular Centre, Departments of Medical Imaging and Neurosurgery, St. Michael's Hospital, Toronto, ON, Canada.
Nicole M. Cancelliere, Neurovascular Centre, Departments of Medical Imaging and Neurosurgery, St. Michael's Hospital, Toronto, ON, Canada.
Abdelaziz Amllay, Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA.
Lukas Meyer, Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Anne Dusart, Department of Neurology, Hôpital Civil Marie Curie, Charleroi, Belgium.
Flavio Bellante, Department of Neurology, Hôpital Civil Marie Curie, Charleroi, Belgium.
Géraud Forestier, Department of Neuroradiology, CHU Limoges Dupuytren, Université de Limoges, Limoges, France.
Aymeric Rouchaud, Department of Neuroradiology, CHU Limoges Dupuytren, Université de Limoges, Limoges, France.
Suzana Saleme, Department of Neuroradiology, CHU Limoges Dupuytren, Université de Limoges, Limoges, France.
Charbel Mounayer, Department of Neuroradiology, CHU Limoges Dupuytren, Université de Limoges, Limoges, France.
Jens Fiehler, Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Anna Luisa Kühn, Department of Radiology, University of Massachusetts Memorial Hospital, Worcester, MA, USA.
Ajit S. Puri, Department of Radiology, University of Massachusetts Memorial Hospital, Worcester, MA, USA.
Christian Dyzmann, Department of Neuroradiology, Sana Kliniken, Lübeck GmbH, Lübeck, Germany.
Peter T. Kan, Department of Neurosurgery, University of Texas Medical Branch, Galveston, TX, USA.
Marco Colasurdo, Department of Neurosurgery, University of Texas Medical Branch, Galveston, TX, USA.
Gaultier Marnat, Department of Interventional Neuroradiology, CHU Bordeaux, Bordeaux, France.
Jérôme Berge, Department of Interventional Neuroradiology, CHU Bordeaux, Bordeaux, France.
Xavier Barreau, Department of Interventional Neuroradiology, CHU Bordeaux, Bordeaux, France.

Author Type(s)

Faculty

Journal Title

Neuroradiology

First Page

631

Last Page

641

Document Type

Article

Publication Date

4-1-2024

Department

Neurosurgery

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.

Recommended Citation

Wang, M., Henkes, H., Ghozy, S., Siegler, J. E., Shaikh, H., Khalife, J., Abdalkader, M., Klein, P., Nguyen, T. N., Heit, J. J., Sweid, A., Naamani, K. E., Regenhardt, R. W., Diestro, J. D., Cancelliere, N. M., Amllay, A., Meyer, L., Dusart, A., Bellante, F., Forestier, G., Rouchaud, A., Saleme, S., Mounayer, C., Fiehler, J., Kühn, A. L., Puri, A. S., Dyzmann, C., Kan, P. T., Colasurdo, M., Marnat, G., Berge, J., & Barreau, X. (2024). Use of the Preset LITE Thrombectomy Device in Combined Approach for Medium Vessel Occlusions: A Multicenter Evaluation. Neuroradiology, 66 (4), 631-641. https://doi.org/10.1007/s00234-024-03302-5