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Stent Placement for Flow Restoration in Acute Ischemic Stroke: A Single-Center Experience with the Solitaire Stent System

Stent Placement for Flow Restoration in Acute Ischemic Stroke: A Single-Center Experience with... This Article Free to Access Figures Only Full Text Full Text (PDF) All Versions of this Article: ajnr.A2505v1 32/7/1245 most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Google Scholar Articles by Stampfl, S. Articles by Rohde, S. PubMed PubMed Citation Articles by Stampfl, S. Articles by Rohde, S. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 32:1245-1248, August 2011 © 2011 American Society of Neuroradiology INTERVENTIONAL Stent Placement for Flow Restoration in Acute Ischemic Stroke: A Single-Center Experience with the Solitaire Stent System S. Stampfl a , M. Hartmann a , P.A. Ringleb b , S. Haehnel a , M. Bendszus a and S. Rohde a a From the Departments of Neuroradiology (S.S., M.H., S.H., M.B., S.R.) b Neurology (P.A.R.), University of Heidelberg, Heidelberg, Germany. Please address correspondence to Sibylle Stampfl, MD, Department of Neuroradiology, University of Heidelberg, INF 400, 69120 Heidelberg, Germany; e-mail: sibyllestampfl@gmx.de BACKGROUND AND PURPOSE: In acute thromboembolic stroke, mechanical recanalization with stents may result in immediate flow restoration. The Solitaire stent can be used both for flow restoration and thrombectomy. In this single-center experience, we report safety and efficacy data on the application of the Solitaire stent. MATERIALS AND METHODS: Between March 2009 and July 2010, 18 patients were treated with the Solitaire stent. To evaluate perfusion of the occluded vessel segment before and after the intervention, the TICI score was used (0–3). Clinical outcome was assessed by using the mRS at discharge. RESULTS: Overall, recanalization was successful in 16 of 18 patients (88.8%). There were no procedure-related complications. Mean TICI score after the intervention was 2.3 ± 0.8. In 5 patients, reocclusion of the treated vessel occurred immediately after retrieval of the temporarily opened stent, and permanent stent deployment was performed to maintain stable perfusion. In 3 patients, hemorrhage occurred after successful recanalization. Five patients died (infarction, n = 3; hemorrhage, n = 1; organ failure, n = 1). A good clinical outcome (mRS 2) was achieved in 33.3% of the patients, 5.5% had a moderate outcome (mRS, 3/4), and 61.2% had a poor outcome or died (mRS, 5/6). CONCLUSIONS: Application of the Solitaire stent in acute stroke results in a high recanalization rate (88.8%) without procedural complications and with a good outcome in one-third of patients. These results encourage further evaluation of the stent in larger patient populations. Abbreviations: IA, intra-arterial • IV, intravenous • MCA, middle cerebral artery • mRS, modified Rankin scale • rtPA, recombinant tissue plasminogen activator • TICI, thrombolysis-in-cerebral-infarction score Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2011 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

Stent Placement for Flow Restoration in Acute Ischemic Stroke: A Single-Center Experience with the Solitaire Stent System

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Publisher
American Journal of Neuroradiology
Copyright
Copyright © 2011 by the American Society of Neuroradiology.
ISSN
0195-6108
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1936-959X
DOI
10.3174/ajnr.A2505
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Abstract

This Article Free to Access Figures Only Full Text Full Text (PDF) All Versions of this Article: ajnr.A2505v1 32/7/1245 most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Google Scholar Articles by Stampfl, S. Articles by Rohde, S. PubMed PubMed Citation Articles by Stampfl, S. Articles by Rohde, S. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 32:1245-1248, August 2011 © 2011 American Society of Neuroradiology INTERVENTIONAL Stent Placement for Flow Restoration in Acute Ischemic Stroke: A Single-Center Experience with the Solitaire Stent System S. Stampfl a , M. Hartmann a , P.A. Ringleb b , S. Haehnel a , M. Bendszus a and S. Rohde a a From the Departments of Neuroradiology (S.S., M.H., S.H., M.B., S.R.) b Neurology (P.A.R.), University of Heidelberg, Heidelberg, Germany. Please address correspondence to Sibylle Stampfl, MD, Department of Neuroradiology, University of Heidelberg, INF 400, 69120 Heidelberg, Germany; e-mail: sibyllestampfl@gmx.de BACKGROUND AND PURPOSE: In acute thromboembolic stroke, mechanical recanalization with stents may result in immediate flow restoration. The Solitaire stent can be used both for flow restoration and thrombectomy. In this single-center experience, we report safety and efficacy data on the application of the Solitaire stent. MATERIALS AND METHODS: Between March 2009 and July 2010, 18 patients were treated with the Solitaire stent. To evaluate perfusion of the occluded vessel segment before and after the intervention, the TICI score was used (0–3). Clinical outcome was assessed by using the mRS at discharge. RESULTS: Overall, recanalization was successful in 16 of 18 patients (88.8%). There were no procedure-related complications. Mean TICI score after the intervention was 2.3 ± 0.8. In 5 patients, reocclusion of the treated vessel occurred immediately after retrieval of the temporarily opened stent, and permanent stent deployment was performed to maintain stable perfusion. In 3 patients, hemorrhage occurred after successful recanalization. Five patients died (infarction, n = 3; hemorrhage, n = 1; organ failure, n = 1). A good clinical outcome (mRS 2) was achieved in 33.3% of the patients, 5.5% had a moderate outcome (mRS, 3/4), and 61.2% had a poor outcome or died (mRS, 5/6). CONCLUSIONS: Application of the Solitaire stent in acute stroke results in a high recanalization rate (88.8%) without procedural complications and with a good outcome in one-third of patients. These results encourage further evaluation of the stent in larger patient populations. Abbreviations: IA, intra-arterial • IV, intravenous • MCA, middle cerebral artery • mRS, modified Rankin scale • rtPA, recombinant tissue plasminogen activator • TICI, thrombolysis-in-cerebral-infarction score Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2011 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X

Journal

American Journal of Neuroradiology – American Journal of Neuroradiology

Published: Aug 1, 2011

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