Endovascular mechanical recanalisation after intravenous thrombolysis in acute anterior circulation stroke: the impact of a new temporary stent

Cardiovasc Intervent Radiol. 2012 Dec;35(6):1326-31. doi: 10.1007/s00270-011-0317-5. Epub 2011 Dec 9.

Abstract

Purpose: Treatment of acute stroke by endovascular mechanical recanalisation (EMR) has shown promising results and continues to be further refined. We evaluated the impact of a temporary stent compared with our results using other mechanical devices.

Materials and methods: We analysed clinical and radiological data of all patients who were treated by EMR after intravenous thrombolysis for acute carotid T- and middle-cerebral artery (M1) occlusions at our centre between 2007 and 2011. A comparison was performed between those patients in whom solely the stent-retriever was applied (group S) and those treated with other devices (group C).

Results: We identified 14 patients for group S and 16 patients for group C. Mean age, National Institute of Health Stroke Scale score, and time to treatment were 67.1 years and 16.5 and 4.0 h for group S and 61.1 years and 17.6 and 4.5 h for group C, respectively. Successful recanalisation (thrombolysis in cerebral infarction scores ≥IIb) was achieved in 93% of patients in group S and 56% of patients in group C (P < 0.05). Mean recanalisation times for M1 occlusions were 23 min (group S) and 29 min (group C) and for carotid-T occlusions were 39 min (group S) and 50 min (group C), and 45% of the patients in group S and 33% in group C had a favourable outcome (Modified Rankin Scale score ≤2).

Conclusion: The findings suggest an improvement in recanalisation success by the application of a temporary stent compared with previously used devices. These results are to be confirmed by larger studies.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carotid Arteries
  • Combined Modality Therapy
  • Device Removal
  • Female
  • Humans
  • Male
  • Middle Aged
  • Middle Cerebral Artery
  • Retrospective Studies
  • Statistics, Nonparametric
  • Stents*
  • Stroke / therapy*
  • Thrombectomy / methods*
  • Thrombolytic Therapy / methods*
  • Tomography, X-Ray Computed
  • Treatment Outcome