Article Text

PDF
Original research
Outcomes of manual aspiration thrombectomy for acute ischemic stroke refractory to stent-based thrombectomy
  1. Seul Kee Kim1,
  2. Woong Yoon1,
  3. Sung Min Moon1,
  4. Man Seok Park2,
  5. Gwang Woo Jeongl,
  6. Heoung Keun Kang1
  1. 1Department of Radiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Republic of Korea
  2. 2Department of Neurology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Republic of Korea
  1. Correspondence to Professor Woong Yoon, Department of Radiology, Chonnam National University Hospital, 671 Jebong-Ro, Dong-gu, Gwangju 501-757, Republic of Korea; radyoon{at}jnu.ac.kr

Abstract

Background and purpose The optimal treatment for patients with acute stroke refractory to stent-based thrombectomy (SBT) is unclear. This study aimed to report clinical outcomes of manual aspiration thrombectomy (MAT) for the treatment of acute ischemic stroke refractory to SBT.

Methods We retrospectively analyzed clinical and angiographic data of 30 patients who underwent MAT with a Penumbra reperfusion catheter because of refractory occlusion after SBT with a Solitaire stent as first-line endovascular therapy. Refractory occlusion was defined by a lack of successful revascularization (defined as Thrombolysis In Cerebral Infarction ≥2b) after five retrieval attempts. A good outcome was defined as a modified Rankin scale score of ≤2 at 3 months.

Results Successful revascularization was achieved in 83.3% (25/30) of the patients who underwent MAT after failed SBT. There was no arterial rupture or dissection or symptomatic intracranial hemorrhage. Two embolic occlusions in a new arterial territory and five subarachnoid hemorrhages occurred, neither of which caused neurological worsening. At the 3-month follow-up, 36.7% (11/30) of patients exhibited a good outcome. The mortality rate was 6.7% (2/30) at 3 months.

Conclusions This study suggests that MAT with the Penumbra reperfusion catheter can further increase the revascularization rate without serious complications in patients with acute stroke with refractory occlusions after SBT with a Solitaire stent.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.