BackTable / VI / Podcast / Episode #144
Direct Aspiration vs. Co-Aspiration for Ischemic Stroke
with Dr. Blaise Baxter and Dr. Satoshi Tateshima
Dr. Sabeen Dhand talks with Dr. Blaise Baxter and Dr. Satoshi Tateshima about direct aspiration vs. co-aspiration technique when treating ischemic stroke. In this first episode of a multi-part series covering treatment of ischemic stroke they discuss radial vs. femoral approach, anatomic considerations, and tips and tricks with both techniques.
BackTable, LLC (Producer). (2021, July 26). Ep. 144 – Direct Aspiration vs. Co-Aspiration for Ischemic Stroke [Audio podcast]. Retrieved from https://www.backtable.com
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Dr. Blaise Baxter
Dr. Blaise Baxter is a practicing Interventional Neuroradiologist in Chattanooga, Tennessee.
Dr. Satoshi Tateshima
Dr. Satoshi Tateshima as a practicing Interventional Neuroradiologist with UCLA Health in Los Angeles, California.
Dr. Sabeen Dhand
Dr. Sabeen Dhand is a practicing interventional radiologist with PIH Health in Los Angeles.
In this episode, neurointerventional specialists Drs. Blaise Baxter, Satoshi Tateshima, and Sabeen Dhand discuss anatomical considerations and procedural techniques in direct aspiration and co-aspiration for ischemic stroke treatment.
The episode starts with a discussion about radial versus femoral approaches. While femoral access remains the most common method, device innovations are making brachial and radial access more available. Dr. Baxter and Dr. Tateshima describe the use of co-aspiration in their frontline techniques. However, Dr. Tateshima notes that he prefers to use direct aspiration in posterior circulation, since the vessel size may be unknown. Dr. Baxter also emphasizes that with co-aspiration, it is important to size-match the catheter with the vessel.
The choice of direct aspiration vs. co-aspiration depends largely on the location of the clot. The doctors walk through different considerations for M1, M2, and M3 strokes. Additionally, they talk about studies that compare the aspiration techniques and outcome factors such as improvements in TICI and mRS scores. Finally, they speak about the rewarding nature of stroke interventions and exciting new developments in the field.
ASTER Randomized Clinical Trial: https://pubmed.ncbi.nlm.nih.gov/28763550/
SAVE vs. ADAPT for Acute Stroke: https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-019-1291-9
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