Tuesday, December 13, 2011

Mechanical thrombectomy in severe acute stroke: preliminary results of the Solitaire stent

Introduction

Intravenous recombinant tissue plasminogen activator (rTPA) therapy has limited recanalisation-rates in large artery occlusions (nadir of 5.9% in Carotid-T-Occlusions).1 Therefore, we prospectively evaluated the Solitaire stent (versions AB and FR, ev3 Inc., Plymouth, Minnesota, USA) in mechanical thrombectomy in acute ischaemic stroke.

Materials and methods

Acute stroke patients were triaged on admission for potential mechanical thrombectomy.

Inclusion criteria

  • – Age ≤80

  • – NIHSS score ≥10, less if symptoms were fluctuating

  • – Onset-to-treatment-time ≤4.5 h or secondary worsening (increase in NIHSS score ≥4). When symptom onset was unclear, patients were eligible if there was mismatch between symptoms and CT-scan

  • – Any brainstem syndrome.

    • Exclusion criteria

  • – Cerebral haemorrhage. Acute infarction >1/3 of middle cerebral artery (MCA) territory on CT-scan.

  • – Prestroke modified Rankin Scale (mRS) score ≥4

    • Eligible patients had immediate CT-angiography without delaying intravenous rTPA-thrombolysis if applicable according...






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