Document Detail


Penumbra system: a novel mechanical thrombectomy device for large-vessel occlusions in acute stroke.
MedLine Citation:
PMID:  20019113     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Large IC artery occlusion is often resistant to recanalization. We present our initial experience with the PS. MATERIALS AND METHODS: Presenting with a severe acute ischemic stroke, the first 27 consecutive patients were considered for thromboaspiration therapy and retrospective data base analysis. All patients received standard thrombectomy treatment as monotherapy or in combination with thrombolysis or IC stent placement. The primary end point was revascularization of the target vessel to grade 2 or 3 on the TICI scale. Secondary end points were improvement of >4 points on the NIHSS score at discharge and favorable outcome, and improvement in overall mortality at 3 months and in sICH- and procedure-related adverse events. RESULTS: At baseline, the mean age was 66 +/- 14 years and the mean NIHSS score was 14 +/- 7. The anterior circulation was affected in 23 patients, and there were 4 basilar artery occlusions. Intracranial stent placement was performed in 4 patients. A recanalization to TICI 2 or 3 was achieved in 25 patients (93%). None of the patients developed sICH. At hospital discharge, 15 patients (56%) had an NIHSS improvement of >4 and 13 patients (48%) had an mRS score of <2 at 3 months. There was a significant correlation between complete vessel recanalization and favorable outcome. The all-cause mortality at 3 months was 11%. CONCLUSIONS: The PS showed a high potential for recanalization of acute thromboembolic occlusions of the large cerebral arteries. Complete recanalization was strongly correlated with good clinical outcome.
Authors:
Z Kulcsár; C Bonvin; V M Pereira; S Altrichter; H Yilmaz; K O Lövblad; R Sztajzel; D A Rüfenacht
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Publication Detail:
Type:  Journal Article     Date:  2009-12-17
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  31     ISSN:  1936-959X     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-13     Completed Date:  2010-07-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  628-33     Citation Subset:  IM    
Affiliation:
Department of Radiology, Geneva University Hospital, Switzerland. kulcsarzsolt22@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Aged, 80 and over
Carotid Artery Thrombosis / mortality,  radiography,  surgery*
Catheterization / instrumentation*
Cerebral Angiography
Combined Modality Therapy
Equipment Design
Female
Fibrinolytic Agents / therapeutic use
Humans
Image Processing, Computer-Assisted
Infarction, Middle Cerebral Artery / mortality,  radiography,  surgery*
Male
Middle Aged
Retrospective Studies
Stents
Suction / instrumentation*
Surgical Instruments*
Survival Rate
Thrombectomy / instrumentation*
Thrombolytic Therapy
Tissue Plasminogen Activator / therapeutic use
Tomography, X-Ray Computed
Vertebrobasilar Insufficiency / mortality,  radiography,  surgery*
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents; EC 3.4.21.68/Tissue Plasminogen Activator

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


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