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Forschungsdatenbank PMU-SQQUID

Influence of a combined CT/C-arm system on periprocedural workflow and procedure times in mechanical thrombectomy.
Pfaff, J; Schonenberger, S; Herweh, C; Pham, M; Nagel, S; Ringleb, PA; Heiland, S; Bendszus, M; Mohlenbruch, M
Eur Radiol. 2017; 27(9):3966-3972
Originalarbeiten (Zeitschrift)

PMU-Autor/inn/en

Pfaff Johannes

Abstract

To achieve the fastest possible workflow in ischaemic stroke, we developed a CT/C-arm system, which allows imaging and endovascular treatment on the same patient table. This prospective, monocentric trial was conducted between October 2014 and August 2016. Patients received stroke imaging and mechanical thrombectomy under general anaesthesia (GA) or conscious sedation (CS) using our combined setup comprising a CT-scanner and a mobile C-arm X-ray device. Primary endpoint was time between stroke imaging and groin puncture. We compared periprocedural workflow and procedure times with the literature and a matched patient cohort treated with a biplane angiographic system before installation of the CT/C-arm system. In 50 patients with acute ischaemic stroke due to large-vessel occlusion in the anterior circulation, comparable recanalization rates were achieved by using the CT/C-arm setup (TICI2b-3:CT/C-arm-GA: 85.7%; CT/C-arm-CS: 90.9%; Angiosuite: 78.6%; p = 0.269) without increasing periprocedural complications. Elimination of patient transport resulted in a significant reduction of the time between stroke imaging and groin puncture: median, min (IQR): CT/C-arm-GA: 43 (35-52); CT/C-arm-CS: 39 (28-49); Angiosuite: 64 (48-74); p < 0.0001. The combined CT/C-arm system allows comparable recanalization rates as a biplane angiographic system and accelerates the start of the endovascular stroke treatment.


Useful keywords (using NLM MeSH Indexing)

Aged

Anesthesia, General/methods

Brain Ischemia/diagnostic imaging

Brain Ischemia/therapy*

Female

Humans

Male

Mechanical Thrombolysis/methods*

Operative Time

Prospective Studies

Stroke/diagnostic imaging

Stroke/therapy*

Time Factors

Tomography, X-Ray Computed/methods

Treatment Outcome

Workflow

X-Rays


Find related publications in this database (Keywords)

Combined CT/C-arm system
Mechanical thrombectomy
Acute ischaemic stroke
Periprocedural workflow
Procedure times