Recanalization with stent-based mechanical thrombectomy in anterior circulation major ischemic stroke

Cohen, José E.; Gomori, John M.; Leker, Ronen R.; Moscovici, Samuel; Ramirez-de-Noriega, Fernando; Itshayek, Eyal

doi:10.1016/j.jocn.2011.06.015

Cited by 27 publications

(13 citation statements)

References 23 publications

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“…Extracranial carotid recanalization was achieved in every case, and complete recanalization with perfusion (TIMI 3, TICI 3/2b) was achieved in four out of five patients, with partial recanalization achieved in the remaining 20%. These rates are comparable to the recanalization rates achieved in patients with isolated proximal MCA occlusions treated by stent-retrievers 24 26 27. Good clinical prognosis and low rates of hemorrhagic complications are also comparable among patients with tandem and single occlusions, supporting the fact that, with this approach, both groups have a similar prognosis.…”

Section: Discussionsupporting

confidence: 64%

Extracranial carotid artery stenting followed by intracranial stent-based thrombectomy for acute tandem occlusive disease

Cohen

Gomori

Rajz

et al. 2014

J NeuroIntervent Surg

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106

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Section: Discussionsupporting

confidence: 64%

Extracranial carotid artery stenting followed by intracranial stent-based thrombectomy for acute tandem occlusive disease

Cohen

Gomori

Rajz

et al. 2014

J NeuroIntervent Surg

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106

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“…Next, 76 articles reporting information about mechanical thrombectomy using the Solitaire stent retrieval in the treatment of acute stroke were retrieved for further screening. Twenty articles were identified as possible candidates for evaluation, of which 7 were excluded for the following reasons: data overlapped with data in the other articles [3-5], insufficient data or case numbers [6-8], and an animal study [9]. The remaining 13 studies [3, 4, 10-21] were included for this review.…”

Section: Resultsmentioning

confidence: 99%

“…The total number of patients included in this review was 262. Seven studies [3, 11, 13, 14, 17, 18, 21] presented individual raw data. The remaining 6 studies [4, 10, 12, 15, 19, 20] presented data as means or medians.…”

Section: Resultsmentioning

confidence: 99%

Safety and Efficacy of Mechanical Thrombectomy with Solitaire Stent Retrieval for Acute Ischemic Stroke: A Systematic Review

2012

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PurposeIn recent years, mechanical thrombectomy using Solitaire stent retrieval has been tried for treating acute ischemic stroke with a large artery occlusion. We systematically reviewed published articles to appraise the evidence that supports the safety and efficacy of the mechanical thrombectomy in acute strokes with Solitaire stent.Materials and MethodsSystematic searches using Medline and Scopus were performed for studies evaluating mechanical thrombectomy using a Solitaire stent in acute ischemic stroke. Articles were included if they were published since 2008, contained at least 5 subjects, and provided clinical results.ResultsThirteen articles (262 cases) were included in this review. The mean time of the procedures ranged from 37 to 95.6 minutes in 10 studies. The success of recanalization was achieved in 89.7% and the recanalization rate varied from 66.7% to 100% in all 13 studies. The overall rates of the symptomatic hemorrhagic complications and mortality were 6.8% and 11.1%, respectively. A favorable outcome of mRS 2 or under was 47.3%. Procedure-induced complications developed in 3.4%.ConclusionThe present review suggested that mechanical thrombectomy using a Solitaire stent in acute ischemic stroke was effective in recanalizing the occluded artery. The rate of procedural complications was small.

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“…The Solitaire device is an intracranial stent that is fully retrievable after full deployment and there is no need for aggressive antiplatelet therapy. Several recent studies suggested a good revascularization rate with the Solitaire stent6,16,18,27).…”

Section: Discussionmentioning

confidence: 99%

Critical Use of Balloon Angioplasty after Recanalization Failure with Retrievable Stent in Acute Cerebral Artery Occlusion

Park

Jang

et al. 2013

J Korean Neurosurg Soc

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ObjectiveSudden major cerebral artery occlusion often resists recanalization with currently available techniques or can results in massive symptomatic intracranial hemorrhage (sICH) after thrombolytic therapy. The purpose of this study was to examine mechanical recanalization with a retrievable self-expanding stent and balloon in acute intracranial artery occlusions.MethodsTwenty-eight consecutive patients with acute intracranial artery occlusions were treated with a Solitaire retrievable stent. Balloon angioplasty was added if successful recanalization was not achieved after stent retrieval. The angiographic outcome was assessed by Thrombolysis in Cerebral Infarction (TICI) and the clinical outcomes were assessed by the National Institutes of Health Stroke Scale (NIHSS) and the modified Rankin Scale (mRS).ResultsAt baseline, mean age was 69.4 years and mean initial NIHSS score was 12.5. A recanalization to TICI 2 or 3 was achieved in 24 patients (85%) after stent retrieval. Successful recanalization was achieved after additional balloon angioplasty in 4 patients. At 90-day follow-up, 24 patients (85%) had a NIHSS improvement of ≥4 and 17 patients (60%) had a good outcome (mRS ≤2). Although there was sICH, there was one death associated with the procedure.ConclusionMechanical thromboembolectomy with a retrievable stent followed by additional balloon angioplasty is a safe and effective first-line therapy for acute intracranial artery occlusions especially in case of unsuccessful recanalization after stent thrombectomy.

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Recanalization with stent-based mechanical thrombectomy in anterior circulation major ischemic stroke

Cited by 27 publications

References 23 publications

Extracranial carotid artery stenting followed by intracranial stent-based thrombectomy for acute tandem occlusive disease

Extracranial carotid artery stenting followed by intracranial stent-based thrombectomy for acute tandem occlusive disease

Safety and Efficacy of Mechanical Thrombectomy with Solitaire Stent Retrieval for Acute Ischemic Stroke: A Systematic Review

Critical Use of Balloon Angioplasty after Recanalization Failure with Retrievable Stent in Acute Cerebral Artery Occlusion

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