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KMID : 1005420120140030203
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Journal of Cerebrovascular and Endovascular Neurosurgery
2012 Volume.14 No. 3 p.203 ~ p.209
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The Limitations of Thrombectomy with Solitaire™AB as First-line Treatment in Acute Ischemic Stroke: A Single Center Experience
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Kim Tae-Kwon
Rhim Jong-Kook
Lee Chung-Jae
Oh Sung-Han
Chung Bong-Sub
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Abstract
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Objective: A self-expanding retrievable intracranial stent, such as Solitaire AB, is useful for mechanical thrombectomy, producing novel results in the treatment of acute ischemic stroke. On the other hand, difficult situations can arise after a thrombectomy when using as in first-line treatment.
Methods: This was a retrospective, single-center study of 23 patients with an acute ischemic stroke attributable to a large artery occlusion within the first eight hours from symptom onset. The occlusion sites were the T segment in five patients, proximal middle cerebral artery in six patients, distal middle cerebral artery in three patients, vertebral and/or basilar artery in five patients, proximal internal cerebral artery in one patient and tandem in three patients. All patients underwent a mechanical thrombectomy using the SolitaireTM stent system as the first-line treatment but required additional procedures due to the unsatisfactory results of a thrombectomy.
Results: Only six patients achieved complete recanalization by a thrombectomy using the Solitaire. Permanent stent deployment after the thrombectomy was performed in ten patients. Stent and balloon angioplasty was performed after a stent-based thrombectomy in six patients. Balloon angioplasty after thrombectomy was performed in one patient.
Conclusion: Mechanical thrombectomy with the SolitaireTM stent as a first-line treatment can produce unfortunate results that will require additional procedures.
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KEYWORD
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Atherosclerosis, Intervention, Stent, Stroke, Thrombectomy
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