Document Detail


Mechanical thrombectomy with the Solitaire AB device in large artery occlusions of the anterior circulation: a pilot study.
MedLine Citation:
PMID:  20538693     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: To describe the safety and effectiveness of a self-expanding and fully retrievable stent (Solitaire AB; ev3 Inc, Plymouth, MN) in revascularization of patients with acute ischemic stroke.
METHODS: Prospective, single-center study of 20 patients with an acute ischemic stroke attributable to a large artery occlusion of the anterior circulation within the first 8 hours from symptoms onset (median National Institutes of Health Stroke Scale, 19 [interquartile range, 15-23]). The occlusion site was middle cerebral artery in 12 patients, proximal internal carotid artery/middle cerebral artery tandem occlusion in 3 patients, and terminus internal carotid artery in 5 patients. Thrombectomy was used as rescue therapy in 2 patients who were refractory to intra-arterial plasminogen activator, and in 3 patients in whom successful recanalization with the MERCI retriever was not achieved.
RESULTS: Successful revascularization defined as thrombosis in cerebral ischemia grade 2b or 3 was achieved in 18 of 20 (90%) treated vessels, and 16 patients showed immediate restoration of flow after stent deployment. The mean number of passes for maximal recanalization was 1.4, and the median (quartiles) time from groin puncture to recanalization was 50 (38-71) minutes. No case required adjuvant therapy after deployment of the embolectomy device. No significant procedural events occurred. Symptomatic intracranial hemorrhage was found in 2 (10%) patients, 4 (20%) patients died during the 90-day follow-up period, and 45% of patients showed good functional outcome at 3 months (modified Rankin Scale score <or=2).
CONCLUSIONS: These results suggest that the Solitaire AB device can rapidly, safely, and effectively retrieve clots from the middle cerebral artery and terminus internal carotid artery within 8 hours from symptoms onset.
Authors:
Carlos Castaño; Laura Dorado; Cristina Guerrero; Monica Millán; Meritxell Gomis; Natalia Perez de la Ossa; Mar Castellanos; M Rosa García; Sira Domenech; Antoni Dávalos
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Publication Detail:
Type:  Letter     Date:  2010-06-10
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  41     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-27     Completed Date:  2010-08-17     Revised Date:  2010-12-23    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1836-40     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Brain Ischemia / therapy*
Cerebral Revascularization / instrumentation*,  methods
Embolectomy / instrumentation*,  methods
Female
Humans
Male
Middle Aged
Middle Cerebral Artery / surgery
Pilot Projects
Prospective Studies
Stents / adverse effects*
Stroke / therapy*
Thrombectomy
Comments/Corrections
Comment In:
Clin Neuroradiol. 2010 Dec;20(4):267-8   [PMID:  21127825 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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