Vol 51, No 1 (2017)

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Single-center experience of stent retriever thrombectomy in acute ischemic stroke

Marcin Wiącek1, Rafał Kaczorowski1, Jarosław Homa1, Edward Filip1, Janusz Darocha1, Daniel Dudek1, Wiesław Guz12, Halina Bartosik-Psujek12
DOI: 10.1016/j.pjnns.2016.09.001
Neurol Neurochir Pol 2017;51(1):12-18.

Abstract

Background and purpose

Recently, positive data from several randomized controlled trials (RCTs) of endovascular therapy for acute ischemic stroke (AIS) has emerged. The aim of this retrospective study is to present our clinical experience in cerebral vessel occlusion treatment using retrievable intracranial stents.

Methods

Forty-three consecutive patients with ischemic stroke (median age 75, range 22–87) treated by stent retriever thrombectomy (Solitaire™ FR) between January 2013 and December 2015 were identified. We retrospectively assessed Thrombolysis in Cerebral Infarction (TICI) scale (2b–3 considered as successful recanalization), clinical outcome using modified Rankin scale (mRs) at 3 months (regarding score 0–2 as good clinical outcome), device-related complications and symptomatic intracranial hemorrhage (sICH; parenchymal hematoma Type 1 or 2 and National Institutes of Health Stroke Scale [NIHSS] score increment ≥4 points) rate.

Results

The mean NIHSS score on admission was 16.4 (median 16). The mean time from onset to groin puncture (time to treatment) was 290min (median 254min). Successful recanalization was achieved in 30 (69.8%) cases. The mean time from onset to successful reperfusion or procedure termination (time to reperfusion) was 394min (median 375min). Good outcome was observed in 17 (39.5%) patients and mortality was 27.9% (n=12). We found 2 (4,7%) sICHs, one (2,3%) thromboembolic event in different vascular territory and one (2,3%) groin hematoma.

Conclusion

Stent retriever thrombectomy for the treatment of ischemic stroke is safe, provides high rate of recanalization and good clinical outcomes in the setting of large vessel occlusion.

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Neurologia i Neurochirurgia Polska