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. 2005 Apr;26(4):875-9.

Mechanical thrombectomy for acute stroke

Eric J Versnick  1 , Huy M Do, Greg W Albers, David C Tong, Michael P Marks
Affiliations

Mechanical thrombectomy for acute stroke

Eric J Versnick et al. AJNR Am J Neuroradiol. 2005 Apr.

Abstract

Background and purpose: We evaluated a mechanical thrombectomy protocol to treat acute stroke and report the angiographic results and clinical outcomes.

Methods: Patients with anterior circulation strokes <8 hours and posterior circulation strokes <12 hours were treated at a single center over 10 months. Patients were excluded if they were candidates for intravenous tissue plasminogen activator (tPA). Treatment involved one of two mechanical thrombectomy devices. Retrieval was augmented by low-dose intra-arterial tPA if needed. Outcome was measured by using the Modified Rankin score.

Results: Ten patients were treated: five with anterior circulation strokes, four with posterior circulation strokes, and one with embolic strokes involving both circulations. Mean National Institutes of Health Stroke Scale score at presentation was 24.6 +/- 10.9. In eight patients (80%), revascularization was successful (Thrombolysis in Acute Myocardial Infarction score, 3). Mean time from symptom onset to initiation of the procedure was 6 hours (5.3 hours for anterior circulation and 7.0 hours for posterior circulation). Mean time for recanalization from the start of the procedure was 1.17 +/- 0.58 hours for the six anterior circulation strokes and 2.75 +/- 1.34 hours in the two posterior circulation strokes. Five patients died within 48 hours; all had posterior circulation strokes. Mean Modified Rankin score at 90 days was 1.4.

Conclusion: In this small series, mechanical thrombectomy of acute stroke appeared to improve recanalization rates compared with intra-arterial thrombolysis. No hemorrhagic complications occurred. Further study is required to determine the role of these techniques.

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Figures

F<sc>ig</sc> 1.
Fig 1.
A 77-year-old man with right-sided weakness and aphasia (NIHSS score, 13) underwent angiography 2.9 hours after the onset of his symptoms. A, Initial angiogram shows a left MCA occlusion. B, After five passes of the Concentric device and 10 mg of tPA, image shows complete recanalization 4.6 hours after initial onset. At 90-day follow-up, he was symptom-free, with a Modified Rankin score of 0.
See this image and copyright information in PMC

References

    1. Furlan A, Higashida R, Weshsler L, et al. Intra-arterial prourokinase for acute ischemic stroke: the PROACT II study—a randomized controlled trial. JAMA. 1999;282:2003–2011 - PubMed
    1. del Zoppo G, Higashida R, Furlan A, et al. PROACT: a phase II randomized trial of recombinant pro-urokinase by direct arterial delivery in acute middle cerebral artery stroke. Stroke. 1998;29:4–11 - PubMed
    1. Fourie P, Duncan I. Microsnare-assisted mechanical removal of intraprocedural distal middle cerebral arterial thromboembolism. Am J Neuroradiol 2003;24:630–632 - PMC - PubMed
    1. Chopko BW, Kerber C, Wong W, Georgy B. Transcatheter snare removal of acute middle cerebral artery thromboembolism: technical case report. Neurosurgery 2000;46:1529–1531 - PubMed
    1. Schumacher HC, Meyers PM, Yavagal DR, et al. Endovascular mechanical thrombectomy of an occluded superior division branch of the left MCA for acute cardioembolic stroke. Cardiovasc Intervent Radiol 2003;26:305–308 - PubMed