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

2. 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%

3. 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

6. 22 patients October 2009- May 2010 Nov 2010

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

9. 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

10. 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

11. 12:58 M1 occlusion

12. 13:06 Placement of the Solitaire device

13. 13:06 Prompt flow restoration

14. 13:08 Thrombus in stent mesh

15. Thrombus from aspiration syringe

16. 13:10 Angiographical outcome

17. Aspirated thrombus & thrombus in device mesh 20/22 90.9% Aspirated thrombus & thrombus in device mesh 20/22 90.9% Stent-assisted Mechanical Recanalization for Treatment of Acute Intracerebral Artery Occlusion Roth C, Papanagiotou P, Reith W et al. Stroke, in press

18. 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

19. 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 reflow.study@me.com