open access
Single-center experience of stent retriever thrombectomy in acute ischemic stroke
- Department of Neurology, Clinical Voivodship Hospital No. 2, Rzeszów, Poland
- Centre for Innovative Research in Medical and Natural Sciences, Faculty of Medicine, University of Rzeszow, Warzywna 1a, 35-959 Rzeszow, Poland
open access
Abstract
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.
MethodsForty-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.
ResultsThe 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.
ConclusionStent 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.
Abstract
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.
MethodsForty-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.
ResultsThe 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.
ConclusionStent 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.
Keywords
AIS, rt-PA, NIHSS, mRS, EVT, DSA, TICI, LVO, IVT, RCTs, sICH
Title
Single-center experience of stent retriever thrombectomy in acute ischemic stroke
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
12-18
Page views
330
Article views/downloads
354
DOI
10.1016/j.pjnns.2016.09.001
Bibliographic record
Neurol Neurochir Pol 2017;51(1):12-18.
Keywords
AIS
rt-PA
NIHSS
mRS
EVT
DSA
TICI
LVO
IVT
RCTs
sICH
Authors
Marcin Wiącek
Rafał Kaczorowski
Jarosław Homa
Edward Filip
Janusz Darocha
Daniel Dudek
Wiesław Guz
Halina Bartosik-Psujek