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KMID : 1141120200060010007
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The Nerve
2020 Volume.6 No. 1 p.7 ~ p.11
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Permanent Stent Deployment for Preventing Vessel Reocclusion after Mechanical Thrombectomy in Acute Ischemic Stroke
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Jwa Cheol-Su
Kim Jae-Hoon
Kang Hee-In
Bae In-Seok
Kim Deok-Ryeong
Moon Byung-Gwan
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Abstract
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Objective: To evaluate the efficacy of permanent stent deployment (SD) using a Solitaire retrieval stent for flow restoration in the reoccluded vessel after mechanical thrombectomy (MT).
Method: We retrospectively investigated 35 acute ischemic stroke patients treated by intraarterial MT using a Solitaire retrieval stent between September 2013 and August 2016. We compared the recanalization rate and clinical outcome between the simple thrombectomy (ST) group and the permanent SD group. The degree of vessel recanalization was graded using thethrombolysis in cerebral infarction (TICI) grading system. The clinical outcomes were assessed using National Institute of Health Stroke Scale score and modified Rankin Scale (mRS) score at 3 months.
Results: Ten of the 35 subjects were treated with permanent SD. The mean initial National Institute of Health Stroke Scale (NIHSS) score was 16.6±4.7 in the ST group and 13.0±4.9 in the SD group. The overall successful recanalization rate (TICI grade 2 or 3) was 84% in the ST group and 70% in the SD group (p=0.381). Procedure-related complications (symptomatic hemorrhage in 1 case, contrast media leakage in 2 cases) occurred in 3 ST patients during MT. There were no significant differences in favorable outcome (decrement of NIHSS score≥4 after MT and mRS score 0-3 at 3 months) between the ST and SD groups (p=0.377 and 0.258, respectively).
Conclusion: Permanent SD as a rescue therapy shows high potential for flowrestoration in the reoccluded vessel, especially when simple MT has failed.
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KEYWORD
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Ischemia, Stents, Stroke, Thrombectomy
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