Mechanical thrombectomy with solitaire stent retrieval for acute ischemic stroke in a Brazilian population
Autor(a) principal: | |
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Data de Publicação: | 2012 |
Outros Autores: | , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Clinics |
Texto Completo: | https://www.revistas.usp.br/clinics/article/view/52281 |
Resumo: | OBJECTIVE: Large vessel occlusion in acute ischemic stroke is associated with low recanalization rates under intravenous thrombolysis. We evaluated the safety and efficacy of the Solitaire AB stent in treating acute ischemic stroke. METHODS: Patients presenting with acute ischemic stroke were prospectively evaluated. The neurological outcomes were assessed using the National Institutes of Health Stroke Scale and the modified Rankin Scale. Time was recorded from the symptom onset to the recanalization and procedure time. Recanalization was assessed using the thrombolysis in cerebral infarction score. RESULTS: Twenty-one patients were evaluated. The mean patient age was 65, and the National Institutes of Health Stroke Scale scores ranged from 7 to 28 (average 17±6.36) at presentation. The vessel occlusions occurred in the middle cerebral artery (61.9%), distal internal carotid artery (14.3%), tandem carotid occlusion (14.3%), and basilarartery (9.5%). Primary thrombectomy, rescue treatment and a bridging approach represented 66.6%, 28.6%, and 4.8% of the performed procedures, respectively. The mean time from symptom onset to recanalization was 356.5±107.8 minutes (range, 80-586 minutes). The mean procedure time was 60.4±58.8 minutes (range, 14-240 minutes). The overall recanalization rate (thrombolysis in cerebral infarction scores of 3 or 2b) was 90.4%, and the symptomatic intracranial hemorrhage rate was 14.2%. The National Institutes of Health Stroke Scale scores at discharge ranged from 0 to 25 (average 6.9±7). At three months, 61.9% of the patients had a modified Rankin Scale score of 0 to 2, with an overall mortality rate of 9.5%. CONCLUSIONS: Intra-arterial thrombectomy with the Solitaire AB device appears to be safe and effective. Large randomized trials are necessary to confirm the benefits of this approach in acute ischemic stroke. |
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Clinics |
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Mechanical thrombectomy with solitaire stent retrieval for acute ischemic stroke in a Brazilian population Acute Ischemic StrokeMechanical ThrombectomyStent RetrievalThrombolysis OBJECTIVE: Large vessel occlusion in acute ischemic stroke is associated with low recanalization rates under intravenous thrombolysis. We evaluated the safety and efficacy of the Solitaire AB stent in treating acute ischemic stroke. METHODS: Patients presenting with acute ischemic stroke were prospectively evaluated. The neurological outcomes were assessed using the National Institutes of Health Stroke Scale and the modified Rankin Scale. Time was recorded from the symptom onset to the recanalization and procedure time. Recanalization was assessed using the thrombolysis in cerebral infarction score. RESULTS: Twenty-one patients were evaluated. The mean patient age was 65, and the National Institutes of Health Stroke Scale scores ranged from 7 to 28 (average 17±6.36) at presentation. The vessel occlusions occurred in the middle cerebral artery (61.9%), distal internal carotid artery (14.3%), tandem carotid occlusion (14.3%), and basilarartery (9.5%). Primary thrombectomy, rescue treatment and a bridging approach represented 66.6%, 28.6%, and 4.8% of the performed procedures, respectively. The mean time from symptom onset to recanalization was 356.5±107.8 minutes (range, 80-586 minutes). The mean procedure time was 60.4±58.8 minutes (range, 14-240 minutes). The overall recanalization rate (thrombolysis in cerebral infarction scores of 3 or 2b) was 90.4%, and the symptomatic intracranial hemorrhage rate was 14.2%. The National Institutes of Health Stroke Scale scores at discharge ranged from 0 to 25 (average 6.9±7). At three months, 61.9% of the patients had a modified Rankin Scale score of 0 to 2, with an overall mortality rate of 9.5%. CONCLUSIONS: Intra-arterial thrombectomy with the Solitaire AB device appears to be safe and effective. Large randomized trials are necessary to confirm the benefits of this approach in acute ischemic stroke. Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2012-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/clinics/article/view/5228110.6061/clinics/2012(12)06Clinics; v. 67 n. 12 (2012); 1379-1386 Clinics; Vol. 67 Núm. 12 (2012); 1379-1386 Clinics; Vol. 67 No. 12 (2012); 1379-1386 1980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/52281/56308Castro-Afonso, Luis Henrique deAbud, Thiago GiansantePontes-Neto, Octávio MarquesMonsignore, Lucas MorettiNakiri, Guilherme SeizemCougo-Pinto, Pedro TellesOliveira, Lívia deSantos, Daniela dosDias, Francisco AFábio, Soraia Cabette RamosColetto, Francisco AntônioAbud, Daniel Giansanteinfo:eu-repo/semantics/openAccess2013-03-08T19:59:51Zoai:revistas.usp.br:article/52281Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2013-03-08T19:59:51Clinics - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Mechanical thrombectomy with solitaire stent retrieval for acute ischemic stroke in a Brazilian population |
title |
Mechanical thrombectomy with solitaire stent retrieval for acute ischemic stroke in a Brazilian population |
spellingShingle |
Mechanical thrombectomy with solitaire stent retrieval for acute ischemic stroke in a Brazilian population Castro-Afonso, Luis Henrique de Acute Ischemic Stroke Mechanical Thrombectomy Stent Retrieval Thrombolysis |
title_short |
Mechanical thrombectomy with solitaire stent retrieval for acute ischemic stroke in a Brazilian population |
title_full |
Mechanical thrombectomy with solitaire stent retrieval for acute ischemic stroke in a Brazilian population |
title_fullStr |
Mechanical thrombectomy with solitaire stent retrieval for acute ischemic stroke in a Brazilian population |
title_full_unstemmed |
Mechanical thrombectomy with solitaire stent retrieval for acute ischemic stroke in a Brazilian population |
title_sort |
Mechanical thrombectomy with solitaire stent retrieval for acute ischemic stroke in a Brazilian population |
author |
Castro-Afonso, Luis Henrique de |
author_facet |
Castro-Afonso, Luis Henrique de Abud, Thiago Giansante Pontes-Neto, Octávio Marques Monsignore, Lucas Moretti Nakiri, Guilherme Seizem Cougo-Pinto, Pedro Telles Oliveira, Lívia de Santos, Daniela dos Dias, Francisco A Fábio, Soraia Cabette Ramos Coletto, Francisco Antônio Abud, Daniel Giansante |
author_role |
author |
author2 |
Abud, Thiago Giansante Pontes-Neto, Octávio Marques Monsignore, Lucas Moretti Nakiri, Guilherme Seizem Cougo-Pinto, Pedro Telles Oliveira, Lívia de Santos, Daniela dos Dias, Francisco A Fábio, Soraia Cabette Ramos Coletto, Francisco Antônio Abud, Daniel Giansante |
author2_role |
author author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Castro-Afonso, Luis Henrique de Abud, Thiago Giansante Pontes-Neto, Octávio Marques Monsignore, Lucas Moretti Nakiri, Guilherme Seizem Cougo-Pinto, Pedro Telles Oliveira, Lívia de Santos, Daniela dos Dias, Francisco A Fábio, Soraia Cabette Ramos Coletto, Francisco Antônio Abud, Daniel Giansante |
dc.subject.por.fl_str_mv |
Acute Ischemic Stroke Mechanical Thrombectomy Stent Retrieval Thrombolysis |
topic |
Acute Ischemic Stroke Mechanical Thrombectomy Stent Retrieval Thrombolysis |
description |
OBJECTIVE: Large vessel occlusion in acute ischemic stroke is associated with low recanalization rates under intravenous thrombolysis. We evaluated the safety and efficacy of the Solitaire AB stent in treating acute ischemic stroke. METHODS: Patients presenting with acute ischemic stroke were prospectively evaluated. The neurological outcomes were assessed using the National Institutes of Health Stroke Scale and the modified Rankin Scale. Time was recorded from the symptom onset to the recanalization and procedure time. Recanalization was assessed using the thrombolysis in cerebral infarction score. RESULTS: Twenty-one patients were evaluated. The mean patient age was 65, and the National Institutes of Health Stroke Scale scores ranged from 7 to 28 (average 17±6.36) at presentation. The vessel occlusions occurred in the middle cerebral artery (61.9%), distal internal carotid artery (14.3%), tandem carotid occlusion (14.3%), and basilarartery (9.5%). Primary thrombectomy, rescue treatment and a bridging approach represented 66.6%, 28.6%, and 4.8% of the performed procedures, respectively. The mean time from symptom onset to recanalization was 356.5±107.8 minutes (range, 80-586 minutes). The mean procedure time was 60.4±58.8 minutes (range, 14-240 minutes). The overall recanalization rate (thrombolysis in cerebral infarction scores of 3 or 2b) was 90.4%, and the symptomatic intracranial hemorrhage rate was 14.2%. The National Institutes of Health Stroke Scale scores at discharge ranged from 0 to 25 (average 6.9±7). At three months, 61.9% of the patients had a modified Rankin Scale score of 0 to 2, with an overall mortality rate of 9.5%. CONCLUSIONS: Intra-arterial thrombectomy with the Solitaire AB device appears to be safe and effective. Large randomized trials are necessary to confirm the benefits of this approach in acute ischemic stroke. |
publishDate |
2012 |
dc.date.none.fl_str_mv |
2012-12-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/52281 10.6061/clinics/2012(12)06 |
url |
https://www.revistas.usp.br/clinics/article/view/52281 |
identifier_str_mv |
10.6061/clinics/2012(12)06 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/52281/56308 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
dc.source.none.fl_str_mv |
Clinics; v. 67 n. 12 (2012); 1379-1386 Clinics; Vol. 67 Núm. 12 (2012); 1379-1386 Clinics; Vol. 67 No. 12 (2012); 1379-1386 1980-5322 1807-5932 reponame:Clinics instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Clinics |
collection |
Clinics |
repository.name.fl_str_mv |
Clinics - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
||clinics@hc.fm.usp.br |
_version_ |
1787713175699849216 |