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Fusion Imaging in Endovascular Thrombectomy for Acute Ischemic Stroke

Landström, Lovisa LU orcid ; Hall, Emma LU orcid ; Hansen, Björn LU orcid and Wasselius, Johan LU (2025) In Stroke: Vascular and Interventional Neurology p.1-13
Abstract
BACKGROUND
Recanalization sometimes fails during endovascular thrombectomy due to target vessel access failure. Two‐dimensional/3‐dimensional fusion imaging in the Siemens ARTIS Icono biplane platform may facilitate access by fusing the preoperative computed tomography angiography with procedural imaging. This observational study aimed to evaluate vascular access, success rates, and procedure times in endovascular thrombectomies with fusion imaging compared to standard treatment.
METHODS
Patients treated with endovascular thrombectomy for ischemic stroke at Skåne University Hospital in Lund, Sweden, were consecutively included. Baseline and procedural characteristics were gathered from radiological patient records. Procedural... (More)
BACKGROUND
Recanalization sometimes fails during endovascular thrombectomy due to target vessel access failure. Two‐dimensional/3‐dimensional fusion imaging in the Siemens ARTIS Icono biplane platform may facilitate access by fusing the preoperative computed tomography angiography with procedural imaging. This observational study aimed to evaluate vascular access, success rates, and procedure times in endovascular thrombectomies with fusion imaging compared to standard treatment.
METHODS
Patients treated with endovascular thrombectomy for ischemic stroke at Skåne University Hospital in Lund, Sweden, were consecutively included. Baseline and procedural characteristics were gathered from radiological patient records. Procedural success rate and lead times such as groin‐to‐recanalization times were evaluated. Associations between fusion imaging and first‐pass recanalization and groin to first pass <30 minutes were also assessed.
RESULTS
Of 347 patients, fusion imaging was used in 68 cases. Failure to reach the occlusion occurred in 6 (2%) of the nonfusion cases compared with none in the fusion group. Successful recanalization (modified Treatment in Cerebral Infarction score ≥2b) was obtained in all fusion cases, compared with 86% in the nonfusion group (P = 0.001). First‐pass recanalization occurred in 72% and 49% of the fusion and nonfusion groups respectively (P<0.001). The groin‐to‐recanalization time was significantly shorter in fusion cases compared with nonfusion (33 versus 43 min, P = 0.04). When adjusting for age and sex, fusion was significantly associated with first‐pass recanalization (odds ratio, 2.70; [95% CI, 1.51–4.86]; P<0.001).
CONCLUSION
Fusion imaging use in the Siemens ARTIS Icono biplane platform in endovascular thrombectomy is not associated with worsened procedural results and appears to decrease failed target artery access risk and increase procedural success rate as well as first‐pass success rate, without procedure prolongation. These initial observational findings need to be further evaluated in prospective randomized studies. (Less)
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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
Stroke: Vascular and Interventional Neurology
article number
e001636
pages
1 - 13
ISSN
2694-5746
DOI
10.1161/SVIN.124.001636
language
English
LU publication?
yes
id
1ffa9327-f2d2-4f6b-84e8-7def9d4ecf3f
date added to LUP
2025-05-26 22:10:39
date last changed
2025-05-28 03:40:03
@article{1ffa9327-f2d2-4f6b-84e8-7def9d4ecf3f,
  abstract     = {{BACKGROUND<br/>Recanalization sometimes fails during endovascular thrombectomy due to target vessel access failure. Two‐dimensional/3‐dimensional fusion imaging in the Siemens ARTIS Icono biplane platform may facilitate access by fusing the preoperative computed tomography angiography with procedural imaging. This observational study aimed to evaluate vascular access, success rates, and procedure times in endovascular thrombectomies with fusion imaging compared to standard treatment.<br/>METHODS<br/>Patients treated with endovascular thrombectomy for ischemic stroke at Skåne University Hospital in Lund, Sweden, were consecutively included. Baseline and procedural characteristics were gathered from radiological patient records. Procedural success rate and lead times such as groin‐to‐recanalization times were evaluated. Associations between fusion imaging and first‐pass recanalization and groin to first pass &lt;30 minutes were also assessed.<br/>RESULTS<br/>Of 347 patients, fusion imaging was used in 68 cases. Failure to reach the occlusion occurred in 6 (2%) of the nonfusion cases compared with none in the fusion group. Successful recanalization (modified Treatment in Cerebral Infarction score ≥2b) was obtained in all fusion cases, compared with 86% in the nonfusion group (P = 0.001). First‐pass recanalization occurred in 72% and 49% of the fusion and nonfusion groups respectively (P&lt;0.001). The groin‐to‐recanalization time was significantly shorter in fusion cases compared with nonfusion (33 versus 43 min, P = 0.04). When adjusting for age and sex, fusion was significantly associated with first‐pass recanalization (odds ratio, 2.70; [95% CI, 1.51–4.86]; P&lt;0.001).<br/>CONCLUSION<br/>Fusion imaging use in the Siemens ARTIS Icono biplane platform in endovascular thrombectomy is not associated with worsened procedural results and appears to decrease failed target artery access risk and increase procedural success rate as well as first‐pass success rate, without procedure prolongation. These initial observational findings need to be further evaluated in prospective randomized studies.}},
  author       = {{Landström, Lovisa and Hall, Emma and Hansen, Björn and Wasselius, Johan}},
  issn         = {{2694-5746}},
  language     = {{eng}},
  pages        = {{1--13}},
  series       = {{Stroke: Vascular and Interventional Neurology}},
  title        = {{Fusion Imaging in Endovascular Thrombectomy for Acute Ischemic Stroke}},
  url          = {{http://dx.doi.org/10.1161/SVIN.124.001636}},
  doi          = {{10.1161/SVIN.124.001636}},
  year         = {{2025}},
}