Stand alone mechanical thrombectomy (with penumbra system) for acute ischemic stroke based on MR imaging: Single center experience

2012 ◽  
Vol 60 (4) ◽  
pp. 406
Author(s):  
Manish Shrivastava ◽  
Darshana Sanghvi ◽  
Shirish Hastak ◽  
Sourabh Lahoti ◽  
Annu Aggarwal
Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Hassan Aboul Nour ◽  
Owais Khadem Alsrouji ◽  
Devashi Dharaiya ◽  
Ghada Mohamed ◽  
Alex Chebl ◽  
...  

Background: Mechanical thrombectomy (MT) for acute ischemic stroke (AIS) in the elderly presents a unique set of challenges and opportunities. Most existing studies include patients up to the age of 90 with stricter criteria of inclusion for patients ≥ 80 years of age. The following study compares the outcomes in octogenarians compared to younger patients in a single center. Methods: We conducted a retrospective chart review of patients who were ≥ 80yo who underwent MT from March 2016 to July 2019. Data on age, recanalization score measured by Thrombolysis in Cerebral Infarction (TICI) score and clinical outcomes were compared to 126 patients < 80 years of age treated during the same time period. Clinical outcomes were classified based on modified Rankin score (mRS) at discharge. Poor outcomes were defined as mRS 4-6. Good recanalization was defined as TICI score 2b or 3. Results: Eighty-three patients with a median age of 86±4.34yo were compared to 126 patients with median age of 63±12.48yo (p<0.0001). Good recanalization was achieved in 74% of patients ≥80yo compared to 84% in patients <80yo (p= 0.06). Poor outcomes were reported in 74.6% of patients ≥80yo compared to 47.0% in patients <80yo (p<0.0001). All-cause mortality was 28.9% in the ≥80yo vs 12.9% in the < 80yo (p=0.006). Conclusion: In our cohort, the clinical outcomes among octogenarians receiving MT were worse than in younger patients despite no difference in recanalization. Various factors may be responsible including overall health status, comorbid conditions and neuroplasticity. Further prospective multicentral studies are needed to better understand the benefit of MT in octogenarians.


Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Ganesh Asaithambi ◽  
Amy L Castle ◽  
Lana J Stein ◽  
Sandra K Hanson ◽  
Jeffrey P Lassig

Background: Recent endovascular stroke studies utilizing primarily stent retrievers have proven clinical benefit among eligible patients. It remains unclear if this benefit is exclusive to stent retrievers. We present the results of a single-center experience for patients undergoing primary aspiration thrombectomy for acute ischemic stroke (AIS). Methods: A retrospective analysis of all AIS patients receiving primary aspiration thrombectomy from January 2014 to March 2016 was performed. We assessed stroke severity at admission and discharge as defined by the National Institutes of Health Stroke Scale score (NIHSSS), median onset to puncture and onset to recanalization times, location of target vessel treated, rate of concurrent intravenous (IV) alteplase use, and rate of TICI 2b/3 reperfusion. Outcomes adjudicated included rates of symptomatic intracerebral hemorrhage (sICH), favorable discharge disposition to home, and 90-day modified Rankin Scale (mRS) score ≤2. Results: During the study period, 121 patients (mean age 68.7±16.5 years, 53.7% women) received primary aspiration thrombectomy for 124 occlusions (26% terminal internal carotid artery, 45% M1, 15% M2, 11% basilar artery, 3% other). Median admission NIHSSS was 19 [11, 22] and improved to 6 [1, 15] upon discharge. Median onset to puncture and onset to recanalization times were 258 [148, 371] and 300 [180, 409] minutes, respectively. The rate of TICI 2b/3 reperfusion was 84.7%, and 52% received adjunctive IV alteplase. Rates of favorable discharge to home was 28.9% and 90-day mRS ≤2 was 39.8%. Only one patient developed sICH. Conclusion: Our single-center experience shows that primary aspiration thrombectomy can yield both favorable angiographic and clinical outcomes with minimal adverse effect.


Stroke ◽  
2012 ◽  
Vol 43 (6) ◽  
pp. 1657-1659 ◽  
Author(s):  
Luis San Román ◽  
Victor Obach ◽  
Jordi Blasco ◽  
Juan Macho ◽  
Antonio Lopez ◽  
...  

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