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

2012 ◽  
Vol 60 (4) ◽  
pp. 400 ◽  
Author(s):  
Keun-Sik Hong ◽  
Ah-Ro Kim ◽  
Yong-Jin Cho ◽  
JiEun Kim ◽  
YoungMin Paek ◽  
...  
Keyword(s):  
Mechanical Thrombectomy ◽  
Artery Occlusion ◽  
Large Artery ◽  
Safety And Efficacy

Safety and Efficacy of Intra-arterial Tirofiban Injection During Mechanical Thrombectomy for Large Artery Occlusion

2020 ◽  
Vol 16 (5) ◽  
pp. 416-424 ◽  
Author(s):  
Ho J. Yi ◽  
Jae H. Sung ◽  
Dong H. Lee
Keyword(s):  
Plasminogen Activator ◽  
Subgroup Analysis ◽  
Mechanical Thrombectomy ◽  
Hemorrhagic Transformation ◽  
Artery Occlusion ◽  
Bleeding Complications ◽  
Large Artery ◽  
Safety And Efficacy ◽  
Tissue Plasminogen ◽  
Occlusion Rate

Objective: The safety and effect of intra-arterial (IA) tirofiban, a glycoprotein IIb/IIIa inhibitor, during the stent retriever mechanical thrombectomy (MT) was investigated. Methods: From January 2015 to May 2019, a total of 327 patients underwent mechanical thrombectomy of large artery occlusions (LAO). Patients were classified into two groups: MT with IA tirofiban (MTT) group and MT only (MTO, without IA tirofiban) group. Clinical outcomes, radiological results, and various complications, such as post thrombectomy hemorrhage, symptomatic hemorrhage, other systemic bleeding, and hemorrhagic transformation of infarct were evaluated by comparing the MTT group and MTO group. In addition, subgroup analysis was performed for patients who underwent MT with prior intravenous (IV) tissue plasminogen activator (t-PA). Results: The MTT group needed a lower mean number of stent passes and showed a re-occlusion rate as compared with the MTO group (P=0.038 and 0.022, respectively). Between the two groups, there were no statistically significant differences in post thrombectomy hemorrhage, symptomatic hemorrhage, other systemic bleeding complications, or hemorrhagic transformation of infarct (P = 0.511, 0.397, 0.429, and 0.355, respectively). In the subgroup analysis, similar findings were observed. Conclusion: The use of IA tirofiban during MT seems to be safe and potentially more effective than only MT without IA tirofiban, even in patients who used IV t-PA before MT.

Bridging Intravenous Thrombolysis Before Mechanical Thrombectomy for Large Artery Occlusion May be Detrimental with Thrombus Fragmentation

2020 ◽  
Vol 17 (1) ◽  
pp. 18-26 ◽  
Author(s):  
Ho Jun Yi ◽  
Jae Hoon Sung ◽  
Dong Hoon Lee
Keyword(s):  
Clinical Outcome ◽  
Subgroup Analysis ◽  
Mechanical Thrombectomy ◽  
Intravenous Thrombolysis ◽  
Artery Occlusion ◽  
Stent Retriever ◽  
Large Artery ◽  
Simultaneous Application

Objective: We investigated whether intravenous thrombolysis (IVT) affected the outcomes and complications of mechanical thrombectomy (MT), specifically focusing on thrombus fragmentation. Methods: The patients who underwent MT for large artery occlusion (LAO) were classified into two groups: MT with prior IVT (MT+IVT) group and MT without prior IVT (MT-IVT) group. The clinical outcome, successful recanalization with other radiological outcomes, and complications were compared, between two groups. Subgroup analysis was also performed for patients with simultaneous application of stent retriever and aspiration. Results: There were no significant differences in clinical outcome and successful recanalization rate, between both groups. However, the ratio of pre- to peri-procedural thrombus fragmentation was significantly higher in the MT+IVT group (14.6% and 16.2%, respectively; P=0.004) compared to the MT-IVT group (5.1% and 6.8%, respectively; P=0.008). The MT+IVT group required more second stent retriever (16.2%), more stent passages (median value = 2), and more occurrence of distal emboli (3.9%) than the MT-IVT group (7.9%, median value = 1, and 8.1%, respectively) (P=0.004, 0.008 and 0.018, respectively). In subgroup analysis, the results were similar to those of the entire patients. Conclusion: Thrombus fragmentation of IVT with t-PA before MT resulted in an increased need for additional rescue therapies, and it could induce more distal emboli. The use of IVT prior to MT does not affect the clinical outcome and successful recanalization, compared with MT without prior IVT. Therefore, we need to reconsider the need for IVT before MT.

Abstract 107: Rescue Tirofiban in Mechanical Thrombectomy for Acute Cerebral Large Artery Occlusion: A Multicenter Prospective Registry Study

Stroke ◽  
2019 ◽  
Vol 50 (Suppl_1) ◽  
Author(s):  
Ming Yang ◽  
Xiaochuan Huo ◽  
Feng Gao ◽  
Anxin Wang ◽  
Xiaoli Zhang ◽  
...  
Keyword(s):  
Mechanical Thrombectomy ◽  
Artery Occlusion ◽  
Large Artery ◽  
Registry Study

Safety and Feasibility of Using Argatroban Immediately After Mechanical Thrombectomy for Large Artery Occlusion

2019 ◽  
Vol 132 ◽  
pp. e341-e349 ◽  
Author(s):  
Jeeyong Kim ◽  
Ho Jun Yi ◽  
Dong Hoon Lee ◽  
Jae Hoon Sung
Keyword(s):  
Mechanical Thrombectomy ◽  
Artery Occlusion ◽  
Large Artery

scholarly journals Stenting as a Rescue Treatment After Failure of Mechanical Thrombectomy for Anterior Circulation Large Artery Occlusion

Stroke ◽  
2016 ◽  
Vol 47 (9) ◽  
pp. 2360-2363 ◽  
Author(s):  
Jang-Hyun Baek ◽  
Byung Moon Kim ◽  
Dong Joon Kim ◽  
Ji Hoe Heo ◽  
Hyo Suk Nam ◽  
...  
Keyword(s):  
Mechanical Thrombectomy ◽  
Artery Occlusion ◽  
Large Artery ◽  
Anterior Circulation ◽  
Rescue Treatment

Abstract 75: A Retrospective Multicenter Study of Solitaire™ FR for Revascularization in the Treatment of Acute Ischemic Stroke

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Antoni Dávalos ◽  
Jan Gralla ◽  
Alain Bonafé ◽  
René Chapot ◽  
Tommy Andersson ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Rescue Therapy ◽  
Artery Occlusion ◽  
Large Artery ◽  
Safety And Efficacy ◽  
Score Improvement ◽  
First Choice ◽  
Device Use ◽  
Solitaire Fr

Background & purpose: To evaluate safety and efficacy of the Solitaire FR in the treatment of patients with acute ischemic stroke (AIS) secondary to large artery occlusion. Methods: Retrospective study of consecutive patients presenting with AIS treated with Solitaire FR as the first choice device to restore blood flow in 6 experienced European sites according to the hospitals’ stroke protocols (direct IA, bridging IV t-PA/IA and failed or contraindicated IV t-PA). Sites provided patient information at pre-procedure, procedure, 24hrs, discharge and 90 days. An independent Core Lab evaluated TICI scores on the pre-procedure and post-procedure angiograms. Recanalization was defined as TICI 2 or 3 post Solitaire FR device use and prior to any rescue therapy. Baseline and post-treatment brain CT or MRI were also centrally reviewed for symptomatic ICH classification (PH2 + death or neurologic deterioration). Good early neurological outcome was defined as NIHSS score improvement of ≥10 points or NIHSS 0,1 at discharge, and favourable functional outcome as modified Rankin Scale (mRS) score ≤ 2 at day 90. Patients with missing mRS data were judged to have worst possible outcome for data analysis. Results: Of the 206 patients treated with Solitaire FR, the device was used as first line treatment in 141 patients (mean age, 66; median NIHSS, 18): 74 patients were treated with IV t-PA prior to endovascular treatment, 56 had contra indication to IV t-PA and 11 were directly treated IA. Safety and efficacy results in the overall and IV t-PA treated patients are shown in the table . The mean number of recoveries was 1.8 and median time from groin puncture to successful revascularization was 45 minutes. Conclusions: This retrospective, uncontrolled study shows that Solitaire FR is safe and achieves good revascularization rates and functional outcomes in patients with AIS and large artery occlusion.

scholarly journals Initial experience with the novel EmboTrap II clot-retrieving device for the treatment of ischaemic stroke

2019 ◽  
Vol 25 (3) ◽  
pp. 271-276 ◽  
Author(s):  
Iacopo Valente ◽  
Sergio Nappini ◽  
Leonardo Renieri ◽  
Alessandro Pedicelli ◽  
Emilio Lozupone ◽  
...  
Keyword(s):  
Ischaemic Stroke ◽  
Acute Ischaemic Stroke ◽  
Mechanical Thrombectomy ◽  
Intravenous Thrombolysis ◽  
Artery Occlusion ◽  
Large Artery ◽  
The Novel ◽  
Neurological Outcomes ◽  
Stent Type ◽  
Radiological Data

Introduction We report our experience with the novel stent-type clot-retrieval device EmboTrap II for the revascularization of large artery occlusions in acute ischaemic stroke. Materials and methods Twenty-nine patients with acute ischaemic stroke due to large artery occlusion underwent mechanical thrombectomy with the new EmboTrap II in two Italian centres. Clinical, procedural and radiological data were collected. Angiographic results and neurological outcomes were analysed. Results Only large vessel occlusions were included. Intravenous thrombolysis was administered in 72% of patients. Successful reperfusion (TICI 2b-3) was obtained in 76% of patients treated exclusively with EmboTrap II. No device-related permanent complications occurred. Conclusion In our experience, mechanical thrombectomy with EmboTrap II is safe and effective. Reperfusion rate was comparable to that obtained with other stent retrievers.

Association of blood viscosity with first-pass reperfusion in mechanical thrombectomy for acute ischemic stroke

2020 ◽  
pp. 1-12
Author(s):  
Kyojun Song ◽  
Ho Jun Yi ◽  
Dong Hoon Lee ◽  
Jae Hoon Sung
Keyword(s):  
Blood Viscosity ◽  
Roc Analysis ◽  
Mechanical Thrombectomy ◽  
Capillary Tube ◽  
Multivariable Analysis ◽  
Artery Occlusion ◽  
Large Artery ◽  
First Pass ◽  
Relationship Of ◽  
The Relationship

BACKGROUND: Elevated blood viscosity has been reported as a risk factor for cerebrovascular disease. OBJECTIVE: The relationship between blood viscosity and outcomes of mechanical thrombectomy (MT) for large artery occlusion (LAO) were investigated in the present study. METHODS: A total of 238 patients were enrolled and systolic blood viscosity (SBV) and diastolic blood viscosity (DBV) were measured using the scanning capillary tube viscometer. Receiver operating characteristic (ROC) analysis was performed to specify the association of viscosity with the first-pass reperfusion (FPR). Multivariable and regression analyses were performed to evaluate the relationship of viscosity with FPR and various variables. RESULTS: Based on ROC analysis, the best DBV cutoff value was 10.55 (cP). In multivariable analysis, high DBV was associated with FPR failure (odds ratio 2.82, 95% confidence interval 1.64–4.22; p = 0.001). Increased DVB could be associated with elevated SBV, hematocrit level, and blood urea nitrogen/creatinine ratio (p = <0.001, 0.004, and 0.002, respectively). CONCLUSIONS: Elevated DBV was associated with FPR failure. Patients with high DBV had longer thrombus length and required more stent passages than patients with low DBV.

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