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Initial experience with the Penumbra Stroke System for recanalization of large vessel occlusions in acute ischemic stroke

  • Interventional Neuroradiology
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Abstract

Introduction

The Penumbra system is a newly approved mechanical device for the treatment of acute stroke designed for better and faster recanalization. We describe our initial experience with the use of this device.

Methods

We studied 27 consecutive patients with acute ischemic strokes due to arterial occlusions presenting at our center from January to October 2009. The primary outcome was the degree of recanalization measured by thrombolysis in myocardial infarction (TIMI grade 2/3) at the end of the procedure. Secondary end points were the proportion of patients who achieved a modified Rankin scale (mRS) ≤2 at 3 months, all-cause mortality and intracerebral hemorrhage (ICH) on non contrast computed tomography at 24 h. Procedural complications were also recorded.

Results

Of 27 patients (13 male, mean age 61 years) in the study, 22 (81%) patients had anterior circulation strokes and five (18%) had posterior circulation strokes. Twenty-three (85%) patients achieved TIMI grade 2/3 recanalization at completion of the procedure. Excluding five patients who needed use of a second device, the Penumbra system achieved TIMI grade 2/3 recanalization in 67% of patients. Thirteen (48%) patients had mRS ≤2 at 3-month follow-up. Procedural and post-procedural complications included vasospasm (3.7%), distal emboli (48.1%), and ICH (33.3%). The distribution of ICH is as follows: hemorrhagic infarct type 1 (25.9%), parenchymal hemorrhage type 1 (3.7%), and parenchymal hemorrhage type 2 (3.7%). All-cause mortality was 19%.

Conclusions

High recanalization rates and good clinical outcomes are achievable with the Penumbra system. Complication rates are comparable to a previously published literature.

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Acknowledgements

We acknowledge the contributions of Drs. Shelagh B. Coutts, Timothy W. J. Watson, Eric E. Smith, Phil Barber, Peter K. Stys, Gary Klein, Stroke fellows and residents, and all other members of the Calgary Stroke Program. We also acknowledge the contribution of the Neuroradiology and Neurosurgery teams at the Foothills Medical Center and technical support from the Seaman Family MR Center.

Conflict of interest statement

MG has received honoraria from Penumbra, Inc. for speaking engagements.

Author information

Authors and Affiliations

  1. Calgary Stroke Program, University of Calgary, Calgary, AB, Canada

    Bijoy K. Menon, Michael D. Hill, Rohit Bhatia & Andrew M. Demchuk

  2. Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada

    Michael D. Hill, John Wong, Mark E. Hudon, Will Morrish, Andrew M. Demchuk & Mayank Goyal

  3. Department of Radiology, University of Calgary, Calgary, AB, Canada

    Michael D. Hill, Muneer Eesa, Jayesh Modi, John Wong, Mark E. Hudon, Will Morrish, Andrew M. Demchuk & Mayank Goyal

  4. Department of Neurosurgery, University of Calgary, Calgary, AB, Canada

    John Wong

  5. Department of Clinical Neurosciences, University of Calgary, EG05, Foothills Hospital, 1403 29 Street NW, Calgary, AB, T2N 2T9, Canada

    Bijoy K. Menon, Michael D. Hill, Rohit Bhatia, John Wong, Mark E. Hudon, Will Morrish, Andrew M. Demchuk & Mayank Goyal

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  1. Bijoy K. Menon
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  2. Michael D. Hill
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Correspondence to Bijoy K. Menon.

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Menon, B.K., Hill, M.D., Eesa, M. et al. Initial experience with the Penumbra Stroke System for recanalization of large vessel occlusions in acute ischemic stroke. Neuroradiology 53, 261–266 (2011). https://doi.org/10.1007/s00234-010-0725-2

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  • DOI: https://doi.org/10.1007/s00234-010-0725-2

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