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




The pREset Stent Retriever for Endovascular Treatment of Stroke Caused by MCA Occlusion: Safety and Clinical Outcome - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Clinical Neuroradiology

, Volume 26, Issue 1, pp 47–55

First Online: 12 August 2014Received: 30 April 2014Accepted: 29 July 2014

Abstract

PurposeThe 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.

MethodsRetrospectively, 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.

ResultsSuccessful 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.

ConclusionsHigh 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.

KeywordsStroke Mechanical thrombectomy Stent retriever pREset MCA occlusion Vessel anatomy List of AbbreviationsAISAcute ischemic stroke

cCTCranial Computed Tomography

MCAMiddle cerebral artery

mRSModified Rankin scale

MTEndovascular mechanical thrombectomy

NIHSSNational Institutes of Health Stroke Scale

RCTRandomized controlled trial

rtPARecombinant tissue plasminogen activator

SAHSubarachnoid hemorrhage

SOPStandard operating procedure

TICIModified thrombolysis in cerebral infarction score

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Autor: B. J. Schwaiger - F. Kober - A. S. Gersing - J. F. Kleine - S. Wunderlich - C. Zimmer - H. Poppert - S. Prothmann

Fuente: https://link.springer.com/



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