A Comparison of Stent-Assisted Mechanical Thrombectomy and Conventional Intra-Arterial Thrombolysis for Acute Cerebral Infarction.
- Author:
Hye Seon JEONG
1
;
Hee Jung SONG
;
Seong Bo KIM
;
Juyoun LEE
;
Chang Woo KANG
;
Hyeon Song KOH
;
Ji Eun SHIN
;
Suk Hoon LEE
;
Hyun Jo KWON
;
Jei KIM
Author Information
- Publication Type:Original Article
- Keywords: acute stroke; mechanical thrombolysis; stent-assisted thrombectomy
- MeSH: Arteries; Cerebral Infarction; Hemorrhage; Humans; Incidence; Mechanical Thrombolysis; Retrospective Studies; Stents; Stroke; Thrombectomy; Thrombosis; Urokinase-Type Plasminogen Activator
- From:Journal of Clinical Neurology 2013;9(2):91-96
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND AND PURPOSE: We evaluated whether stent-assisted thrombectomy (SAT) is safer or more clinically beneficial than aggressive mechanical clot disruption (AMCD) for patients with acute intracranial artery occlusion. METHODS: We retrospectively analyzed the clinical data of 72 patients (33 with SAT and 39 with AMCD) who underwent intra-arterial thrombolysis for acute intracranial artery occlusions. Procedure parameters, clinical outcomes, and incidence of complications were compared between the SAT and AMCD groups. RESULTS: The time interval to recanalization was shorter in SAT patients (69.2+/-39.6 minutes, mean+/-standard deviation) than in AMCD patients (94.4+/-48.0 minutes, p<0.05). Recanalization was achieved in more SAT patients (91%) than AMCD patients (80%), but with no statistically significance. Urokinase was used less frequently in SAT patients (21%) than in AMCD patients (92%, p<0.05), and the incidence of symptomatic hemorrhages was lower in SAT patients (3%) than in AMCD patients (18%, p<0.05). Device-related complications in SAT patients comprised two cases of stent fracture and one case of distal migration of a captured thrombus. The proportion of patients with good outcomes, defined as scores from 0 to 3 on the modified Rankin Scale, was similar in the two groups at discharge (SAT, 46%; AMCD, 39%), but significantly higher in the SAT group than in the AMCD group at 3 months (64% vs. 40%, p<0.05) and 6 months (67% vs. 42%, p<0.05) after discharge. CONCLUSIONS: The outcomes and clinical parameters were better for SAT during thrombolytic procedures for acute intracranial artery occlusions than for AMCD for up to 6 months. However, some device-related complications occurred during stent interventions.
