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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 28:860-863, May 2007
© 2007 American Society of Neuroradiology

INTERVENTIONAL

Rapid Intracranial Clot Removal with a New Device: The Alligator Retriever

C.W. Kerber^a, I. Wanke^b, J. Bernard, Jr.^c, H.H. Woo^d, M.W. Liu^e and P.K. Nelson^f

^a Department of Neuroradiology, University of California, San Diego Medical Center, San Diego, Calif
^b Department of Neuroradiology, University Hospital of Essen, Essen, Germany
^c Carolina Neurosurgery and Spine Associates, Charlotte, NC
^d Section of Cerebrovascular and Endovascular Neurosurgery, Cleveland Clinic Foundation, Cleveland, Ohio
^e Division of Neurosurgery, Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
^f Department of Radiology, New York University Medical Center, New York

Please address correspondence to Charles Kerber, MD, UCSD Medical Center, 200 West Arbor Dr, San Diego, CA 92103-8756; e-mail: kaos{at}ucsd.edu

BACKGROUND AND PURPOSE: Despite availability of an approved drug to treat acute cerebral ischemia, most patients with stroke do not realize a good outcome. A method that would rapidly increase or restore cerebral perfusion before irreversible cell death should improve patient outcomes.

MATERIALS AND METHODS: We recently had the opportunity to treat 6 middle-aged-to-elderly patients who presented with signs and symptoms of acute cerebral ischemia, by mechanically removing their (predominantly) middle cerebral artery clots by using a new retrieval device that had been previously approved by the US Food and Drug Administration for intravascular retrieval of foreign bodies. During a 2-month period, the 6 patients were treated in 5 separate institutions. No patient had an unsuccessful attempt at clot removal. The cases were collected by personal communication with each operator.

RESULTS: In all instances, use of the device resulted in rapid clot removal. Each patient had a large improvement in National Institutes of Health Stroke Scale score. Two of the 6 patients had experienced failure of another clot retrieval device, and 3 patients required no systemic thrombolytics, reducing the likelihood of one of the most feared complications of stroke therapy, intracranial hemorrhage.

SUMMARY: We believe that use of this device may result in improved outcomes for patients with acute ischemic stroke. In our limited experience, it provided a rapid, safe, and effective means for achieving revascularization.

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