Safety of the Solitaire 4 × 40 mm Stent Retriever in the Treatment of Ischemic Stroke.

Zibold, Felix; Mordasini, Pasquale; Mosimann, Pascal John; Piechowiak, Eike Immo; Dobrocky, Tomas; Fischer, Urs; Arnold, Marcel; Bellwald, Sebastian; Gralla, Jan (2018). Safety of the Solitaire 4 × 40 mm Stent Retriever in the Treatment of Ischemic Stroke. Cardiovascular and interventional radiology, 41(1), pp. 49-54. Springer 10.1007/s00270-017-1785-z

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PURPOSE Stent retrievers apply mechanical force to the intracranial vasculature. Our aim was to evaluate the safety and efficacy of the long Solitaire 4 × 40 mm stent retriever for large vessel occlusion in stroke patients. METHODS We conducted a retrospective analysis of all patients treated for acute ischemic large vessel occlusion stroke with the Solitaire 2 FR 4 × 40 device between May and October 2016 at our institution. Patient-specific data at baseline and at discharge were documented. Reperfusion was graded with the thrombolysis in cerebral infarction (TICI) classification. Postinterventional angiograms and follow-up cross-sectional imaging were used to evaluate complications. RESULTS TICI 2b/3 recanalization was achieved in 20 of 23 patients (87.0%), in 17 patients with the first retriever pass. NIHSS improved from a mean score at presentation of 16 (range 4-36) to 11 (range 0-41) at discharge. Mean mRS score at discharge was 3 (range 0-6) and 3 (range 0-6) at 90 days post-treatment. No infarcts in other territories were observed. One patient showed a (reversible) vasospasm in the postinterventional angiogram and another a small contrast extravasation in follow-up imaging. CONCLUSION The Solitaire 2 FR 4 × 40 stent retriever is a safe and efficient device for large vessel occlusion acute ischemic stroke with a high recanalization rate and a low peri- and postinterventional complication rate together with a good clinical outcome. Despite potentially higher friction and shearing forces, no increased incidence of visible damage to the vessel wall was observed.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Zibold, Felix; Mordasini, Pasquale; Mosimann, Pascal John; Piechowiak, Eike Immo; Dobrocky, Tomas; Fischer, Urs; Arnold, Marcel; Bellwald, Sebastian and Gralla, Jan

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0174-1551

Publisher:

Springer

Language:

English

Submitter:

Stefanie Hetzenecker

Date Deposited:

07 Nov 2017 11:13

Last Modified:

25 Apr 2018 12:18

Publisher DOI:

10.1007/s00270-017-1785-z

PubMed ID:

28864867

Uncontrolled Keywords:

Friction force Mechanical forces Reports of complications Straightening of vessel course

BORIS DOI:

10.7892/boris.105254

URI:

https://boris.unibe.ch/id/eprint/105254

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