Stent Retrievers in Acute Ischemic Stroke: Complications and Failures during the Perioperative Period

Abstract

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.

Comparison of Modern Stroke Thrombectomy Approaches Using an In Vitro Cerebrovascular Occlusion Model

“…Embolic events can occur in up to 12% of cases of Stentriever thrombectomy and are associated with a 2-fold increase in mortality compared with cases without embolic complications. 12 In our experiments, we observed the presence of substantial ENT with all approaches except for direct aspiration; however, regarding EDT events, no technique protects effectively from this occurrence. Nguyen et al 13 published their experience with the use of the balloon-guide catheter in conjunction with Solitaire FR stent retriever thrombectomy.…”

Effect of Intracranial Atherosclerotic Disease on Endovascular Treatment for Patients with Acute Vertebrobasilar Occlusion

“…This incidence is much higher than that in the Western population, in which intracranial stenosis was observed in only 5.5% of patients with stent-retriever thrombectomy. 28 On the contrary, intracranial stenosis was observed in 22.9% of patients with multimodal endovascular treatment in a Korean study. 29 IAD may be more frequent in the posterior circulation than in the anterior circulation.…”

Double Solitaire Mechanical Thrombectomy in Acute Stroke: Effective Rescue Strategy for Refractory Artery Occlusions?

“…3,4 Despite considerable recanalization rates of 61%-86% (Thrombolysis in Myocardial Infarction/TICI scores of Ն2/2b), [3][4][5] up to 33.3% of patients are still left without sufficient recanalization after standard SR MT. 6 In these refractory cases, different rescue treatments have been proposed with variable rates of success. 4,5,[7][8][9][10] These include local intra-arterial fibrinolysis, MT with the Penumbra device (Penumbra, Alameda, California), mechanical thrombus disruption, thromboaspiration through a distal-access catheter (DAC), balloon angioplasty, and/or stent placement.…”