Background and Purpose-Large vessel occlusion in ischemic stroke is associated with a high degree of morbidity. When intravenous thrombolysis fails, mechanical thrombectomy can provide an alternative and synergistic method for flow restoration. In this study we evaluate the safety and efficacy of our stroke management protocol (RECOST study). Methods-Fifty consecutive ischemic stroke patients with large vessel occlusion were included. After clinical and MRI imaging assessment, 3 treatment strategies were selected according to time of symptom onset and location of vessel occlusion: rescue therapy; combined therapy; and stand-alone thrombectomy (RECOST study). MRI ASPECT score Ͻ5 was the main exclusion criterion. Mechanical thrombectomy was performed exclusively with the Solitaire flow restoration device. Clinical outcome was assessed after treatment, on day 1, and at discharge. Results-Mean patient age was 67.6 years, mean NIHSS score was 14.7, and mean ASPECT score was 6 on presentation.Vessel occlusions were in the middle cerebral artery (40%), the internal carotid artery (28%), and the basilar artery (32%). Rescue treatment represented 24%, combined therapy represented 56%, and stand-alone thrombectomy represented 20%. Mean recanalization time from symptoms onset was 377 minutes, with overall recanalization rate TICI 3 of 84%. NIHSS score at discharge was 6.5, with 60% of patients demonstrating NIHSS score 0 to 1 or an improvement of Ͼ9 points. Symptomatic complication rate was 10%. At 3 months, 54% of patients had a modififed Rankin scale score of 0 to 2, with an overall mortality rate of 12%. Conclusions-The present integrated stroke management protocol (RECOST study) demonstrated rapid, safe, and effective recanalization. We postulate that the Solitaire device contributed to high recanalization and patient selection using MRI ASPECT score to low and complication rates, therefore avoiding futile and dangerous interventions. (Stroke.

BACKGROUND AND PURPOSE: Stent retriever-assisted thrombectomy promotes high recanalization rates in acute ischemic stroke. Nevertheless, complications and failures occur in more than 10% of procedures; hence, there is a need for further investigation.

Background and purposePrompt recanalization of cerebral arteries in patients diagnosed with acute ischemic stroke is known to be associated with a better clinical outcome. The aim of this study was to present our initial experience regarding the efficacy and safety of the Solitaire FR as a revascularization device.Methods56 consecutive patients presenting with acute ischemic stroke underwent intra-arterial therapy using the Solitaire FR revascularization device. Immediate angiographic results and early clinical outcomes are presented.ResultsSolitaire FR was successful in achieving recanalization in 50 out of 56 patients (89%) with a final Thrombolysis in Cerebral Infarction score ≥2b. Five out of 56 patients had procedure related complications: two asymptomatic subarachnoid hemorrhages, two thromboembolic events and one symptomatic intracranial hemorrhage (PH2). Thirty patients (53.5%) demonstrated at discharge a National Institutes of Health Stroke Scale Score of ≤1 or an improvement of at least 10 points from baseline, and 26 patients (46%) had a modified Rankin Score ≤2.ConclusionsSolitaire FR is successful in achieving a high rate of arterial recanalization with a low complication rate. The Solitaire FR is a promising thrombectomy tool with a high degree of effectiveness, safety and ease of use.

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EVT of MCA aneurysms was safe and long-term monitoring of patients showed a low rate of recurrence requiring retreatment. However, complex anatomy and long-term recurrences have to be addressed when considering EVT for MCA aneurysms.

BACKGROUND AND PURPOSE:Clinical outcome and initial and midterm angiographic results of EVT of complex MCA aneurysms by using the stent-assisted coiling technique were retrospectively evaluated in our center where EVT of intracranial aneurysms is the first treatment option.

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BACKGROUND AND PURPOSE:The purpose of this study was to evaluate the benefits of endovascular intervention in large-vessel occlusion strokes, depending on age class.