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Preliminary experience with the use of self-expanding stent as a thrombectomy device in ischemic stroke.
MedLine Citation:
PMID:  21801598     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
MATERIALS AND METHODS: Six patients (mean age 55 years, range 35-71 years) presented with major ischemic stroke secondary to large vessel occlusion. Patients had a National Institutes of Health Stroke Scale score of >17, no intracerebral hemorrhage or early infarction, and poor collateral supply to the affected parenchyma. Within 6 hours of symptom onset, a stent (Solitaire, ev3, Irvine, CA, USA) was deployed across the entire occluded segment. Repeat angiogram was performed to evaluate the reconstituted flow. The balloon of the guide catheter was inflated for proximal carotid occlusion. The partially deployed stent was slowly pulled back (mechanical thrombectomy step) under continuous aspiration. Suction was repeated to ensure the aspiration of any clot remnants.
RESULTS: In all the cases, complete recanalization (Thrombolysis in Myocardial Infarction Revascularization and Reperfusion Score of 3) was achieved in <60 minutes after femoral access, and a single thrombectomy attempt was sufficient to achieve clot removal. No stent was permanently implanted. Modified Rankin Scores were 0-2 in all patients at a mean 1-month follow-up.
CONCLUSIONS: The presented approach allowed three desired effects: rapid endovascular revascularization, clot removal, and no need of leaving a permanent implant. In our preliminary experience this simple and rapid stent-based mechanical thrombectomy technique has had an unprecedented success rate.
Authors:
José E Cohen; John M Gomori; Ronen R Leker; Roni Eichel; David Arkadir; Eyal Itshayek
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurological research     Volume:  33     ISSN:  1743-1328     ISO Abbreviation:  Neurol. Res.     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-08-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7905298     Medline TA:  Neurol Res     Country:  England    
Other Details:
Languages:  eng     Pagination:  214-9     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Hadassah-Hebrew University Medical Center Jerusalem, Israel.
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