Recanalization of Acute Occlusions of Cerebral Arteries Using a Retrievable Stent

Czech version

Authors: A. Krajina ¹; V. Chovanec ¹; D. Krajíčková ²; M. Lojík ¹; J. Raupach ¹; T. Česák ²; Z. Špriňar ¹; R. Taláb ²; P. Ryška ¹; V. Dostálová ³; O. Renc ¹; S. Řehák ⁴
Authors‘ workplace: LF UK a FN Hradec Králové Radiologická klinika ¹; LF UK a FN Hradec Králové Neurologická klinika ²; LF UK a FN Hradec Králové Klinika anesteziologie, resuscitace a intenzivní medicíny ³; LF UK a FN Hradec Králové Neurochirurgická klinika ⁴
Published in: Cesk Slov Neurol N 2012; 75/108(1): 75-79
Category: Short Communication

Overview

Purpose:
To describe the effectiveness of a retrievable stent for mechanical thrombectomy in patients with acute ischemic stroke.

Materials and methods:
A retrospective, single-center study included 12 patients with embolic occlusion of large arteries treated according to the mechanical thrombembolectomy protocol. The patients were treated between 2009 and 2011. A selfexpandable and retrievable stent was used for revascularization in all patients (8 women and 4 men of mean age of 63.3 years). There were embolic occlusions of the M1 segment in 11 patients, in combination with occlusion of the internal carotid artery in two of them and one occlusion of the A2 segment of the anterior cerebral artery. The median NIHSS was 17. Thrombembolectomy with retrievable stent was used as a rescue therapy in 3 patients treated with Merci retriever.

Results:
Successful recanalization of TIMI 2 and 3 was achieved in all 12 patients with additional reopening of extracranial internal carotid arteries. One stent was deployed at the level of embolic occlusion after two failed attempts to remove a clot from A2 segment. Symptomatic intracranial hemorrhage was found in two patients. Three months after the therapy, 75% of patients were independent (mRS ≤2).

Conclusions:
Our results show that the retrievable selfexpandable stent can safely and rapidly retrieve clots from intracranial arteries.

Key words:
stroke – mechanical thrombembolectomy – cerebral revascularization – angiography

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