Purpose
Since a relative short time,
stent retrievers have been used for endovascular treatment of acute ischemic stroke.
Originally they were used to treat wide-necked aneurysms,
in a way that the stents would transitorily seal the neck during the embolization to avoid coil herniation.
Once the aneurysm was embolized,
the stents were then extracted.
It was this extraction characteristic,
described in 2008,
found as peculiarly useful for endovascular treatment of ischemic stroke,
because it allowed the extraction of thrombus attached to the stent,
achieving arterial recanalization...
Methods and Materials
We present the results of 10 patients treated in our institution using endovascular Mindframe Capture® stent retrievers for the extraction of distal vessels thrombus in the acute ischemic stroke context.
These 10 patients came to the hospital with neurological symptoms and within the therapeutic window since the symptoms onset.
The stroke code was activated according to established criteria and endovascular therapy was performed.
In our series the time of evolution since the neurological symptoms begun until the stroke code activation,
fluctuated between 45 minutes minimum...
Results
Using the stent retriever Mindframe Capture® an adequate arterial recanalization was achieved in 9 patients -TICI 3 in 7 cases and TICI 2b in two cases-,
which means 90% of the patients.
Arterial recanalization failed in 1 case (TICI 0).
Three patients presented intracerebral hemorrhage in control CT performed during the first 24 hours after the intervention; one of them suffered severe intracerebral hemorrhage in basal ganglia immediately after the procedure,
with mass effect over basal cistern and midline displacement.
The patient evolved negatively with...
Conclusion
In this series of 10 patients in which distal arterial endovascular thrombectomy was done with stent retrievers (Mindframe Capture® stent retrievers),
and adequate recanalization was achieved in 9 of them (TICI 2b and TICI 3),
which means a 90% of the series.
These results are similar to percentages obtained by using stent-retrievers in larger proximal arteries according to recent series
[1-2].
Concerning complications,
there were 3 cases of intracranial hemorrhage post procedure,
one of which was symptomatic -equivalent to 10% of the series-.
This percentage...
References
1.
Pasquale Mordasini.
Thrombectomy for Acute Ischemic Stroke Treatment: A Review.
EJMINT Invited Review,
2012: 1238000077.
21st September 2012.
2.
Vitor Mendes Pereira.
Use of Stentrievers in Acute Stroke: Tips,
Tricks,
and Current Results.
Tech Vasc Interventional Rad 15:68-77.
2012.
3.
R.G.
Nogueira.
Endovascular Approaches to Acute Stroke,
Part 1: Drugs,
Devices,
and Data.
AJNR Am J Neuroradiol 30:649–61.
Apr 2009.
4.
Marta Aguilar Pérez.Intracranial thrombectomy using the Solitaire stent: a historical vigente.
J NeuroIntervent Surg.
November 2011.
5.
A Aleu Bonaut.
Nuevas técnicas de...