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  • Mechanical thrombectomy by Solitaire AB stent for Treatment of Acute Ischemic Stroke: A Single-Center Experience in China

    Final Number:
    265

    Authors:
    Yi Jonathan Zhang MD; Shao-Wei Jiang; Ya Peng; Jing-Gang Xuan; Rong-Hua Chen; Xu-Cheng Zhu; Yi-Ling Yang

    Study Design:
    Other

    Subject Category:
    Cerebrovascular

    Meeting: AANS/CNS Cerebrovascular Section 2014 Annual Meeting

    Introduction: Mechanical thrombectomy devices are gaining popularity in large vessel occlusion where chemical thrombolysis is usually ineffective. The aim of this study is to report single center experiences in Chinese patients with acute ischemic stroke who had undergone mechanical thrombectomy by Solitaire AB stent thrombectomy device.

    Methods: A retrospective review from 12/2010 to 04/2013 was performed on patients who underwent mechanical thrombectomy with Solitaire AB stent for large vessel occlusion. The main inclusion criteria were: NIH Stroke score =10; treatment within 8hr from onset of symptoms and no large infarct on CT or MRI; and occlusion of a major cerebral artery on CT angiogram or MRA. Recanalization rates were assessed immediately by angiography, using TICI score. Neurological evaluation (NIHSS) was performed before treatment and at discharge. Assessment of the modified Rankin Scale (mRS) was performed 90 days after treatment.

    Results: Fifty-five consecutive patients were included. The mean patient age was 60.8 years (range 21-84 years), and NIHSS ranged from 10 to 25 (average 17.8±4.3) at presentation. The vessel occlusions occurred in middle cerebral artery (69.1%), distal internal carotid artery (7.3%), internal carotid artery with tandem MCA occlusion (20%), and basilar artery (1.8%). Successful recanalization was achieved in 48 of 55 patients (87.3%). A complete recanalization (TICI 3) state was accomplished in 34 (61.8% )patients , and partial recanalization (TICI 2a/2b) was achieved in 14 (25.5%) patients. NIHSS scores at discharge ranged from 0 to 18 (average 8.0±7.7). At 90-day follow-up, good clinical outcome (mRS =2) was achieved in 24 of 55 patients (43.6%), while 7 patients died, with an overall mortality rate of 12.7% for the study group.

    Conclusions: The study revealed a high rate of angiographic recanalization using Solitaire AB stent device. Use of Solitaire AB stent in acute stroke is safe, time-efficient and encouraging. However, future prospective randomized large trials are required to confirm these early results.

    Patient Care: Indicates a need for large and prospective study for roles of mechanical thrombectomy in large vessel acute ischemic stroke

    Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the indication and strategy in mechanical thrombectomy for large vessel occlusive acute stroke; 2) Discuss, in small groups,the safety and efficacy of Solitaire thrombectomy in acute ischemic large vessel stroke.

    References:

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