Self-Expandable Stents in the Treatment of Acute Ischemic Stroke Refractory to Current Thrombectomy Devices

Italo LINFANTE; Edgar A SAMANIEGO; Philipp GEISBÜSCH; Guilherme DABUS

doi:10.1161/STROKEAHA.111.618389

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$Self-Expandable Stents in the Treatment of Acute Ischemic Stroke Refractory to Current Thrombectomy Devices$

Journal article

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Peer reviewed

Self-Expandable Stents in the Treatment of Acute Ischemic Stroke Refractory to Current Thrombectomy Devices

Italo LINFANTE, Edgar A SAMANIEGO, Philipp GEISBÜSCH and Guilherme DABUS

Stroke (1970), Vol.42(9), pp.2636-2638

2011

DOI: 10.1161/STROKEAHA.111.618389

PMID: 21719774

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Abstract

Background and Purpose— Vessel recanalization is a strong predictor of good outcome in acute ischemic strokes (AIS) secondary to large vessel occlusions. We report our single-center experience with self-expandable stents in the treatment of AIS. Methods— The stroke database of Baptist Cardiac and Vascular Institute in Miami was retrospectively reviewed from August of 2008 to September of 2010. All cases of AIS in which a self-expandable stents was deployed as acute endovascular intervention were included in the analysis. Criteria for intervention were the onset of neurological symptoms because of AIS, a National Institute of Health Stroke Scale score ≥4 at presentation, stroke attributable to a large vessel occlusion, and failure of arterial thrombolysis or mechanical thrombectomy or both. Good outcome was defined as a modified Rankin Scale score ≤2 at 1 month from hospital discharge. Results— Nineteen patients with AIS who underwent stenting were identified. Median National Institute of Health Stroke Scale score on admission was 19. Six Enterprise and 13 Wingspan stents were deployed. Recanalization was achieved in 95% occlusions (63% thrombolysis in myocardial infarction grade 3 and 32% thrombolysis in myocardial infarction grade 2). Good clinical outcome was achieved in 42%. No intraprocedural complications occurred and all stents were successfully deployed. Symptomatic intracerebral hemorrhage occurred in 3 (16%) patients, 2 of whom died. Conclusions— Use of self-expandable stents in AIS appears to be safe and may be considered when currently available thrombectomy devices and/or intraarterial thrombolysis fail.

Neurology

Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy

Biological and medical sciences

Vascular diseases and vascular malformations of the nervous system

Medical sciences

Nervous system (semeiology, syndromes)

Details

Title: Subtitle: Self-Expandable Stents in the Treatment of Acute Ischemic Stroke Refractory to Current Thrombectomy Devices
Creators: Italo LINFANTE - Baptist Cardiac and Vascular Institute, Miami, FL, United States
Edgar A SAMANIEGO - Baptist Cardiac and Vascular Institute, Miami, FL, United States
Philipp GEISBÜSCH - Baptist Cardiac and Vascular Institute, Miami, FL, United States
Guilherme DABUS - Baptist Cardiac and Vascular Institute, Miami, FL, United States
Resource Type: Journal article
Publication Details: Stroke (1970), Vol.42(9), pp.2636-2638
Publisher: Lippincott Williams & Wilkins; Hagerstown, MD
DOI: 10.1161/STROKEAHA.111.618389
PMID: 21719774
ISSN: 0039-2499
eISSN: 1524-4628
Language: English
Date published: 2011
Academic Unit: Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
Record Identifier: 9984020759502771

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