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The combined use of mechanical thrombectomy devices is feasible for treating acute carotid terminus occlusion.

Authors
Lee, JS; Hong, JM; Lee, SJ; Joo, IS; Lim, YC; Kim, SY
Citation
Acta neurochirurgica, 155(4):635-641, 2013
Journal Title
Acta neurochirurgica
ISSN
0001-62680942-0940
Abstract
BACKGROUND: Mechanical thrombectomy devices have recently been developed and approved for recanalization of intracranial arterial occlusion. Here, we investigated the feasibility of combined stent-assisted and clot aspiration mechanical thrombectomy for effective recanalization of acute carotid terminus occlusion (CTO).



METHODS: Ten consecutive patients with acute ischemic stroke secondary to CTO who underwent intra-arterial (IA) treatment with both stent retrieval and negative-pressured clot aspiration systems were enrolled. Periprocedural and radiologic findings and clinical outcomes were evaluated.



RESULTS: The median age was 69 years (range, 47-86 years), and the median initial NIHSS score was 17.5 (range, 12-33). Mechanical thrombectomy was performed using a combination of the Solitaire stents and Penumbra system. Thrombolysis in cerebral ischemia [TICI] grade II-III was achieved in eight patients (80.0 %); complete recanalization of the CTO (TICI III) was achieved in three of those patients. Any type of intracranial hemorrhages occurred in four patients (40.0 %), but parenchymal hematoma type 2 was not observed. Four patients died within 3 months (40.0 %).



CONCLUSIONS: Combined mechanical thrombectomy treatment was effective for recanalization of acute CTO. The combination of Solitaire and Penumbra devices can be considered as a treatment option for CTO.
MeSH terms
AgedAged, 80 and overBrain Ischemia/*surgeryCarotid Artery Diseases/*surgeryCerebral Angiography/methodsFemaleHumansMaleMiddle AgedStroke/*surgeryThrombectomy/*instrumentationTreatment Outcome
DOI
10.1007/s00701-013-1649-5
PMID
23435866
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Neurosurgery
Journal Papers > School of Medicine / Graduate School of Medicine > Radiology
Journal Papers > School of Medicine / Graduate School of Medicine > Neurology
AJOU Authors
이, 진수홍, 지만주, 인수임, 용철김, 선용
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