Mechanical Thrombectomy with Solitaire Stent Retrieval for Acute Cardioembolic Stroke.
10.3340/jkns.2016.0707.003
- Author:
Hokyun HAN
1
;
Hyunho CHOI
;
Keun Tae CHO
;
Byong Cheol KIM
Author Information
1. Department of Neurosurgery, Dongguk University Ilsan Hospital, Goyang, Korea. han850317@naver.com
- Publication Type:Original Article
- Keywords:
Intracranial embolism;
Mechanical thrombolysis
- MeSH:
Cerebral Infarction;
Follow-Up Studies;
Humans;
Intracranial Embolism;
Mechanical Thrombolysis;
Stents*;
Stroke*;
Thrombectomy*;
Thrombosis
- From:Journal of Korean Neurosurgical Society
2017;60(6):627-634
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Few studies have reported the outcome of mechanical thrombectomy with Solitaire stent retrival (MTSR) in subtypes of acute ischemic stroke. The purpose of this study was to evaluate the efficacy and result of MTSR in acute cardioembolic stroke. METHODS: Twenty consecutive patients with acute cardioembolic stroke were treated by MTSR. The angiographic outcome was assessed by thrombolysis in cerebral infarction (TICI) grade. TICI grade 2a, 2b, or 3 with a measurable thrombus that was retrieved was considered as a success when MTSR was performed in the site of primary vessel occlusion, and TICI grade 2b or 3 was considered as a success when final result was reported. Clinical and radiological results were compared between two groups divided on the basis of final results of MTSR. Persistent thrombus compression sign on angiogram was defined as a stenotic, tapered arterial lumen whenever temporary stenting was performed. The clinical outcomes were assessed by the modified Rankin Scale (mRS) at 3 months. RESULTS: The failure rate of MTSR was 20% (4/20) and other modalities, such as permanent stenting, were needed. Final successful recanalization (TICI grade 2b or 3) was 80% when other treatments were included. The rate of good outcome (mRS≤2) was 35% at the 3-month follow-up. Failure of MTSR was significantly correlated with persistent thrombus compression sign (p=0.001). CONCLUSION: Some cases of cardioembolic stroke are resistant to MTSR and may need other treatment modalities. Careful interpretation of angiogram may be helpful to the decision.
