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Endovascular Mechanical Recanalisation of Acute Carotid-T Occlusions: A Single-Center Retrospective Analysis

  • Clinical Investigation
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Abstract

Purpose

Acute carotid-T occlusion generally responds poorly to thrombolysis. Endovascular mechanical thrombectomy (EMT) seems to be a promising alternative. However, there are few data on EMT in carotid-T occlusions.

Materials and Methods

We reviewed data of 14 consecutive patients with acute carotid-T occlusions treated with mechanical recanalisation devices. A clot separation/aspiration system was used in 11 patients; different other mechanical retriever devices were used in seven patients; and stents were used in four patients. Modified Rankin Scale scores at 90 days were recorded to assess functional outcome.

Results

Six women and eight men were included in the study. Mean patient age was 59.2 years; median National Institute of Health Stroke Scale score on admission was 19; and mean time to treatment was 4.2 h. Successful recanalisation (Thrombolysis in Myocardial Infarction [TIMI] score II and III) was achieved in 11 patients (78.6%). Seven patients (50.0%) were treated with more than one device, leading to successful recanalisation in six of these patients (85.7%). Subarachnoid haemorrhage and large space-occupying bleedings occurred in one (7.1%) and three (21.4%) patients, respectively. At follow-up, three patients (21.4%) were functionally independent, and six (42.9%) had died.

Conclusion

When applying different mechanical devices, we found a high recanalisation rate. However, discrepancy between recanalisation and clinical outcome remained. More data are needed to assess the effect of the different methods on the prognoses of stroke patients.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Neuroradiology, University of Munich, Klinikum Grosshadern, Marchioninistr. 15, 81377, Munich, Germany

    Gunther Fesl, Maximilian Patzig, Markus Holtmannspoetter & Hartmut Brueckmann

  2. Department of Diagnostic and Interventional Neuroradiology, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany

    Martin Wiesmann

  3. Department of Neurology, University of Munich, Klinikum Grosshadern, Marchioninistr. 15, 81377, Munich, Germany

    Thomas Pfefferkorn & Martin Dichgans

  4. Interdisciplinary Stroke Center Munich, University of Munich, Klinikum Grosshadern, Marchioninistr. 15, 81377, Munich, Germany

    Gunther Fesl, Martin Wiesmann, Maximilian Patzig, Markus Holtmannspoetter, Thomas Pfefferkorn, Martin Dichgans & Hartmut Brueckmann

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  1. Gunther Fesl
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Correspondence to Gunther Fesl.

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Fesl, G., Wiesmann, M., Patzig, M. et al. Endovascular Mechanical Recanalisation of Acute Carotid-T Occlusions: A Single-Center Retrospective Analysis. Cardiovasc Intervent Radiol 34, 280–286 (2011). https://doi.org/10.1007/s00270-010-9980-1

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  • DOI: https://doi.org/10.1007/s00270-010-9980-1

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