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The pREset Stent Retriever for Endovascular Treatment of Stroke Caused by MCA Occlusion: Safety and Clinical Outcome

PURPOSE: The purpose of this study was to analyze the safety and efficacy of the pREset device, a stent retriever system, for endovascular mechanical thrombectomy (MT) in acute ischemic stroke (AIS) after middle cerebral artery (MCA) occlusion. METHODS: Retrospectively, 48 consecutive patients (mean...

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Autores principales: Schwaiger, B. J., Kober, F., Gersing, A. S., Kleine, J. F., Wunderlich, S., Zimmer, C., Poppert, H., Prothmann, S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4833806/
https://www.ncbi.nlm.nih.gov/pubmed/25112831
http://dx.doi.org/10.1007/s00062-014-0329-z
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author Schwaiger, B. J.
Kober, F.
Gersing, A. S.
Kleine, J. F.
Wunderlich, S.
Zimmer, C.
Poppert, H.
Prothmann, S.
author_facet Schwaiger, B. J.
Kober, F.
Gersing, A. S.
Kleine, J. F.
Wunderlich, S.
Zimmer, C.
Poppert, H.
Prothmann, S.
author_sort Schwaiger, B. J.
collection PubMed
description PURPOSE: The purpose of this study was to analyze the safety and efficacy of the pREset device, a stent retriever system, for endovascular mechanical thrombectomy (MT) in acute ischemic stroke (AIS) after middle cerebral artery (MCA) occlusion. METHODS: Retrospectively, 48 consecutive patients (mean age ± standard deviation, 71.0 ± 11.9 years; 24 women) treated for acute MCA occlusion using pREset solely or in combination with other MT devices were identified. Recanalization success was evaluated using the modified thrombolysis in cerebral infarction score (TICI), and complications were detected by 24-h follow-up computed tomography or magnetic resonance imaging. MCA anatomy was assessed in angiograms. Clinical outcome was evaluated with National Institutes of Health Stroke Scale (NIHSS) score at admission and discharge, and modified Rankin scale (mRS) score at discharge and follow-up. RESULTS: Successful recanalization (TICI 2b/3) was achieved in 39 patients (81.3 %). Rate of procedure-related complications was 8.3 %. In four patients, a subarachnoid hemorrhage occurred (8.3 %), and parenchymal hematoma was detected in four patients (8.3 %). None of those events was associated with clinical deterioration. MCA curvature significantly influenced recanalization success (P < 0.005). Successful recanalization correlated significantly with lower NIHSS scores and favorable clinical outcome (mRS score 0–2) at discharge (P < 0.05). Mortality within 90 days was significantly lower in patients with TICI 2b/3 (P < 0.005). CONCLUSIONS: High recanalization rates, low complication rates, and a significantly improved outcome after successful recanalization strongly suggest that MT with pREset is an adequate therapy for AIS after MCA occlusion. Vessel curvature is a significant determining factor for recanalization success.
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spelling pubmed-48338062016-04-25 The pREset Stent Retriever for Endovascular Treatment of Stroke Caused by MCA Occlusion: Safety and Clinical Outcome Schwaiger, B. J. Kober, F. Gersing, A. S. Kleine, J. F. Wunderlich, S. Zimmer, C. Poppert, H. Prothmann, S. Clin Neuroradiol Original Article PURPOSE: The purpose of this study was to analyze the safety and efficacy of the pREset device, a stent retriever system, for endovascular mechanical thrombectomy (MT) in acute ischemic stroke (AIS) after middle cerebral artery (MCA) occlusion. METHODS: Retrospectively, 48 consecutive patients (mean age ± standard deviation, 71.0 ± 11.9 years; 24 women) treated for acute MCA occlusion using pREset solely or in combination with other MT devices were identified. Recanalization success was evaluated using the modified thrombolysis in cerebral infarction score (TICI), and complications were detected by 24-h follow-up computed tomography or magnetic resonance imaging. MCA anatomy was assessed in angiograms. Clinical outcome was evaluated with National Institutes of Health Stroke Scale (NIHSS) score at admission and discharge, and modified Rankin scale (mRS) score at discharge and follow-up. RESULTS: Successful recanalization (TICI 2b/3) was achieved in 39 patients (81.3 %). Rate of procedure-related complications was 8.3 %. In four patients, a subarachnoid hemorrhage occurred (8.3 %), and parenchymal hematoma was detected in four patients (8.3 %). None of those events was associated with clinical deterioration. MCA curvature significantly influenced recanalization success (P < 0.005). Successful recanalization correlated significantly with lower NIHSS scores and favorable clinical outcome (mRS score 0–2) at discharge (P < 0.05). Mortality within 90 days was significantly lower in patients with TICI 2b/3 (P < 0.005). CONCLUSIONS: High recanalization rates, low complication rates, and a significantly improved outcome after successful recanalization strongly suggest that MT with pREset is an adequate therapy for AIS after MCA occlusion. Vessel curvature is a significant determining factor for recanalization success. Springer Berlin Heidelberg 2014-08-12 2016 /pmc/articles/PMC4833806/ /pubmed/25112831 http://dx.doi.org/10.1007/s00062-014-0329-z Text en © Springer-Verlag Berlin Heidelberg 2014
spellingShingle Original Article
Schwaiger, B. J.
Kober, F.
Gersing, A. S.
Kleine, J. F.
Wunderlich, S.
Zimmer, C.
Poppert, H.
Prothmann, S.
The pREset Stent Retriever for Endovascular Treatment of Stroke Caused by MCA Occlusion: Safety and Clinical Outcome
title The pREset Stent Retriever for Endovascular Treatment of Stroke Caused by MCA Occlusion: Safety and Clinical Outcome
title_full The pREset Stent Retriever for Endovascular Treatment of Stroke Caused by MCA Occlusion: Safety and Clinical Outcome
title_fullStr The pREset Stent Retriever for Endovascular Treatment of Stroke Caused by MCA Occlusion: Safety and Clinical Outcome
title_full_unstemmed The pREset Stent Retriever for Endovascular Treatment of Stroke Caused by MCA Occlusion: Safety and Clinical Outcome
title_short The pREset Stent Retriever for Endovascular Treatment of Stroke Caused by MCA Occlusion: Safety and Clinical Outcome
title_sort preset stent retriever for endovascular treatment of stroke caused by mca occlusion: safety and clinical outcome
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4833806/
https://www.ncbi.nlm.nih.gov/pubmed/25112831
http://dx.doi.org/10.1007/s00062-014-0329-z
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