Neurol India Home 
 

TOPIC OF THE ISSUE: ORIGINAL ARTICLE
Year : 2012  |  Volume : 60  |  Issue : 4  |  Page : 400--405

Safety and efficacy of mechanical thrombectomy with the Solitaire device in large artery occlusion

Ji Eun Kim1, Ah-Ro Kim1, Young Min Paek1, Yong-Jin Cho2, Byung-Hoon Lee3, Keun-Sik Hong2 
1 Department of Neurology, Inje University, Ilsan Paik Hospital, Gyeonggi-do, South Korea
2 Department of Neurology; Stroke Center, Inje University, Ilsan Paik Hospital, Gyeonggi-do, South Korea
3 Stroke Center; Department of Radiology, Inje University, Ilsan Paik Hospital, Gyeonggi-do, South Korea

Correspondence Address:
Keun-Sik Hong
Department of Neurology, Ilsan Paik Hospital, Inje University, 2240 Daewha-dong, Ilsanseo-gu, Goyang City, Gyeonggi-do
South Korea

Background and Purpose: Intravenous tissue plasminogen activator (TPA) has limited efficacy in proximal large vessel occlusions. This study was to assess the safety and efficacy of mechanical thrombectomy with a retrievable Solitaire stent in acute large artery occlusions . Materials and Methods: This is a single center study enrolling patients treated with Solitaire-assisted thrombectomy between November 2010 and March 2011. Inclusion criteria were severe stroke of National Institutes of Health Stroke Scale (NIHSS) score ≥10, treatment initiation within 6 hours from onset, and an angiographically verified occlusion of proximal middle cerebral artery (MCA) or internal carotid artery (ICA). The primary outcome was recanalization defined as Thrombolysis in Cerebral Infarct (TICI) reperfusion grade 2b/3. Secondary outcomes were good functional outcome at 3 months (modified Rankin Scale [mRS] ≤2), early substantial neurological improvement (NIHSS score improvement ≥8 at 24 hours), and symptomatic hemorrhagic transformation (SHT). Results: Ten patients were consecutively enrolled: Age: 72.4 ΁ 5.7 years; female: 70%; baseline median NIHSS score: 19.5; and ICA occlusion in 50% and M1 portion of MCA occlusion in 50%. Six patients received intravenous TPA before intra-arterial treatment, and five patients were treated with adjuvant intra-arterial urokinase. Successful recanalization was achieved in 7 (70%) patients. Four (40%) patients had a good functional outcome at 3 months, and three (30%) patients had an early substantial neurological improvement. SHT occurred in two patients (20%), and 3-month mortality rate was 30%. There was no procedure-related complication. Conclusions: Mechanical thrombectomy with the Solitaire device can effectively recanalize proximal large vessel occlusions, and potentially improves clinical outcome.


How to cite this article:
Kim JE, Kim AR, Paek YM, Cho YJ, Lee BH, Hong KS. Safety and efficacy of mechanical thrombectomy with the Solitaire device in large artery occlusion.Neurol India 2012;60:400-405


How to cite this URL:
Kim JE, Kim AR, Paek YM, Cho YJ, Lee BH, Hong KS. Safety and efficacy of mechanical thrombectomy with the Solitaire device in large artery occlusion. Neurol India [serial online] 2012 [cited 2021 Sep 21 ];60:400-405
Available from: https://www.neurologyindia.com/article.asp?issn=0028-3886;year=2012;volume=60;issue=4;spage=400;epage=405;aulast=Kim;type=0