Endovascular Mechanical Recanalisation After Intravenous Thrombolysis in Acute Anterior Circulation Stroke: The Impact of a New Temporary Stent

被引:11
作者
Fesl, Gunther [1 ,2 ]
Patzig, Maximilian [1 ,2 ]
Holtmannspoetter, Markus [1 ,2 ]
Mayer, Thomas E. [3 ]
Pfefferkorn, Thomas [2 ,4 ]
Opherk, Christian [2 ,4 ]
Brueckmann, Hartmut [1 ,2 ]
Wiesmann, Martin [5 ]
机构
[1] Univ Munich, Klinikum Grosshadern, Dept Neuroradiol, D-81377 Munich, Germany
[2] Univ Munich, Klinikum Grosshadern, Interdisciplinary Stroke Ctr Munich, D-81377 Munich, Germany
[3] Univ Jena, Dept Neuroradiol, D-07747 Jena, Germany
[4] Univ Munich, Klinikum Grosshadern, Dept Neurol, D-81377 Munich, Germany
[5] Rhein Westfal TH Aachen, Univ Hosp, Dept Diagnost & Intervent Neuroradiol, D-52074 Aachen, Germany
关键词
Acute stroke; Recanalisation; Endovascular mechanical thrombectomy; Anterior circulation; Temporary stent; Stent retriever; ACUTE ISCHEMIC-STROKE; TISSUE-PLASMINOGEN ACTIVATOR; THROMBECTOMY; DEVICE; SAFETY; EXPERIENCE; EFFICACY; TRIAL;
D O I
10.1007/s00270-011-0317-5
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Treatment of acute stroke by endovascular mechanical recanalisation (EMR) has shown promising results and continues to be further refined. We evaluated the impact of a temporary stent compared with our results using other mechanical devices. We analysed clinical and radiological data of all patients who were treated by EMR after intravenous thrombolysis for acute carotid T- and middle-cerebral artery (M1) occlusions at our centre between 2007 and 2011. A comparison was performed between those patients in whom solely the stent-retriever was applied (group S) and those treated with other devices (group C). We identified 14 patients for group S and 16 patients for group C. Mean age, National Institute of Health Stroke Scale score, and time to treatment were 67.1 years and 16.5 and 4.0 h for group S and 61.1 years and 17.6 and 4.5 h for group C, respectively. Successful recanalisation (thrombolysis in cerebral infarction scores a parts per thousand yenIIb) was achieved in 93% of patients in group S and 56% of patients in group C (P < 0.05). Mean recanalisation times for M1 occlusions were 23 min (group S) and 29 min (group C) and for carotid-T occlusions were 39 min (group S) and 50 min (group C), and 45% of the patients in group S and 33% in group C had a favourable outcome (Modified Rankin Scale score a parts per thousand currency sign2). The findings suggest an improvement in recanalisation success by the application of a temporary stent compared with previously used devices. These results are to be confirmed by larger studies.
引用
收藏
页码:1326 / 1331
页数:6
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