Stent-assisted Mechanical Recanalization for Treatment of Acute Intracerebral Artery Occlusion C. Roth ‡, P. Papanagiotou ‡, S. C.

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Presentation transcript:

Stent-assisted Mechanical Recanalization for Treatment of Acute Intracerebral Artery Occlusion C. Roth ‡, P. Papanagiotou ‡, S. C. W. Reith ‡ Department of Diagnostic and Interventional Neuroradiology ‡ Department of Saarland University Hospital, Homburg, Germany

Recanalization rate mRS 0-2 ICH 69.5%36%9.8% 72.4%37.9% 5%45% (mRS 0-1)100% 7% 81.6%25%11.2%

Stenting in acute stroke Prompt flow- restoration High recanalization rate Fast recanalization Aggressive anticoagulation Thrombus is only pressed against the wall In-Stent stenosis possible AdvantagesDisadvantages

22 patients October May 2010 Nov 2010

Patients 13/22 patients iv lysis 10/22 patients ia lysis Solitaire AB/FR

angiographical outcome TICI 2b or 3 in 20/22 patients 90.9% Number of device runs 1.74(1-4) Vasospasm 3/22 (13.6%) Stent-assisted Mechanical Recanalization for Treatment of Acute Intracerebral Artery Occlusion Roth C, Papanagiotou P, Reith W et al. Stroke, in press

clinical outcome symptomatic ICH: 2/22 (9%) Stent-assisted Mechanical Recanalization for Treatment of Acute Intracerebral Artery Occlusion Roth C, Papanagiotou P, Reith W et al. Stroke, in press

12:58 M1 occlusion

13:06 Placement of the Solitaire device

13:06 Prompt flow restoration

13:08 Thrombus in stent mesh

Thrombus from aspiration syringe

13:10 Angiographical outcome

Aspirated thrombus & thrombus in device mesh 20/ % Aspirated thrombus & thrombus in device mesh 20/ % Stent-assisted Mechanical Recanalization for Treatment of Acute Intracerebral Artery Occlusion Roth C, Papanagiotou P, Reith W et al. Stroke, in press

recanalizationmRS 0-2 ICH 69.5%36%9.8% 72.4%37.9%7% 81.6%25%11.2% 5%45% (mRS 0-1)100% 90.9%50%9% Nov 2010

Mechanical REcanalization with FLOW Restoration in Acute Ischemic Stroke ReFlow Study Monocentric Prospective Trial 40 Patients Primary endpoint: favourable clinical outcome at 30 and 90 days (mRS 0 to2) Solitaire FR Recanalization Device Saarland University Hospital, Homburg, Germany