Aims and objectives
The aim of this study is to investigate the efficacy and safety in the setting of acute permanent intracranial stenting after failed mechanical thrombectomy (MT) in acute ischemic stroke (AIS).
MT has become standard in acute ischemic stroke treatment in patients with large-vessel occlusion.
However in some patients MT has been reported to fail due to an underlying intracranial stenosis,
wall-adherent thrombi or dissection.
In those cases permanent stenting may be needed to obtain sufficient recanalization.
Methods and materials
We retrospectively reviewed records of patients treated with intracranial stents for AIS at our department between 2013 and 2017.
Clinical,
angiographic and neuroimaging data were analyzed.
Neurological status was evaluated with the NIHSS score at admission and with the mRS score at discharge and after 3 months.
The endpoints of this study were recanalization,
clinical outcome at 3 months,
symptomatic intracranial hemorrhage (sICH) and mortality at 90 days.
Results
Forty patients underwent permanent intracranial stenting after MT for AIS.
Seventeen of the stents were self-expanding,
23 were drug eluting.
Twenty occlusions were located in the anterior and 20 in the posterior circulation. Fifty percent of the patients received IV tPA prior to interventional therapy.
Bolus of GP IIb/IIIa inhibitors were administered periprocedural to prevent in-stent-thrombosis by most of the patients.
Revascularization was achieved in 93 % (37/40). The early good functional outcome of mRS≤2 after 90 days was 42,5 % (17/40).
In-hospital mortality was...
Conclusion
Our study suggests that acute permanent intracranial stenting after failed MT is feasible,
effective and has a low risk of reperfusion-related symptomatic hemorrhage.
Personal information
M.
Boutchakova-Meyer
Clinic Bremen -Mitte,
Department of diagnostic and interventional Neuroradiology
St.-Jürgen-Str.
1
28205 Bremen,
Germany
Phone: + 494214973625
Fax: + 494214973622
e-mail :
[email protected]
References
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