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. 2018 Feb;7(1-2):6-11.
doi: 10.1159/000480245. Epub 2017 Sep 27.

Permanent Deployment of the Solitaire FR™ Device in the Basilar Artery in an Acute Stroke Scenario

Miguel S Litao  1 , Erez Nossek  1 , Keith DeSousa  1 , Albert Favate  1 , Eytan Raz  1 , Maksim Shapiro  1 , Tibor Becske  1 , Peter Kim Nelson  1
Affiliations

Permanent Deployment of the Solitaire FR™ Device in the Basilar Artery in an Acute Stroke Scenario

Miguel S Litao et al. Interv Neurol. 2018 Feb.

Abstract

Background: Scarce reports exist of permanent deployment of Solitaire FR™ devices for arterial steno-occlusive disease as it is primarily indicated for temporary deployment for thrombectomy in large-vessel, anterior-circulation ischemic strokes. Even more scarce are reports describing permanent deployment of the Solitaire device for posterior circulation strokes.

Summary: We present 2 cases where the Solitaire device was electrolytically detached to re-establish flow in an occluded or stenotic basilar artery in acutely symptomatic patients. In both cases, a 4 × 15 mm Solitaire device was positioned across the stenotic or occluded portion of the basilar artery and electrolytically detached to maintain vessel patency. Both cases had good clinical outcomes with a National Institutes of Health Stroke Scale (NIHSS) score of 1 (from 24) on 90-day follow-up and an NIHSS score of 2 (from 7) on 30-day follow-up.

Key messages: Permanent deployment of the Solitaire device may potentially be a safe and effective means of maintaining vessel patency in an occluded or stenotic basilar artery.

Keywords: Acute stroke; Solitaire; Thrombectomy.

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Figures

Fig. 1
Fig. 1
Digital subtraction angiography showing proximal basilar occlusion. 49 × 52 mm (300 × 300 DPI).
Fig. 2
Fig. 2
2 × 9 mm Maverick balloon microcatheter in the occluded segment. 114 × 76 mm. 45 × 48 mm (300 × 300 DPI).
Fig. 3
Fig. 3
4 × 15 mm Solitaire FR device positioned and electrolytically detached across the diseased segment. 51 × 51 mm (300 × 300 DPI).
Fig. 4
Fig. 4
TICI 3 recanalization after 204 min from groin puncture. 53 × 56 mm (300 × 300 DPI).
Fig. 5
Fig. 5
Digital subtraction angiography showing 90% of stenosis of the proximal to mid-portion of the basilar artery. 35 × 38 mm (300 × 300 DPI).
Fig. 6
Fig. 6
0.014-inch Transcend wire advanced through the stenosed segment with the distal wire tip in the right P2 segment. 38 × 59 mm (300 × 300 DPI).
Fig. 7
Fig. 7
Post-balloon angioplasty to 10 atm 3 times with no sufficient dilatation achieved. 37 × 41 mm (300 × 300 DPI).
Fig. 8
Fig. 8
4 × 15 mm Solitaire FR device electrolytically detached resulting in decrease in stenosis from 90% to 50%. 32 × 48 mm (300 × 300 DPI).
See this image and copyright information in PMC

References

    1. Berkhemer OA, Puck SS, Fransen MD, Beumer D, van den Berg LA, Lingsma HF, et al. MR CLEAN Investigators A randomized trial of intraarterial treatment for acute ischemic stroke. N Engl J Med. 2015;372:11–20. - PubMed
    1. Goyal M, Demchuk AM, Menon BK, Eesa M, Rempel JL, Thornon J, et al. ESCAPE Trial Investigators Randomized assessment of rapid endovascular treatment of ischemic stroke. N Engl J Med. 2015;372:1019–1030. - PubMed
    1. Campbell BCV, Mitchell PJ, Kleinig TJ, Dewey HM, Churiloy L, Yassi N, et al. EXTEND-IA Investigators Endovascular therapy for ischemic stroke with perfusion-imaging selection. N Engl J Med. 2015;372:1009–1018. - PubMed
    1. Saver JL, Goyal M, Diener HC, Levy EI, Pereira VM, et al. SWIFT PRIME Investigators Stent-retriever thrombectomy after intravenous t-PA versus t-PA alone in stroke. N Engl J Med. 2015;372:2285–2295. - PubMed
    1. Jovin TG, Chamorro A, Cobo E, de Miquel M, Molina CA, Rovira A, et al. REVASCAT Trial Investigators Thrombectomy within 8 h after symptom onset in ischemic stroke. N Engl J Med. 2015;372:2296–2306. - PubMed

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