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Case series
Permanent implantation of the Solitaire device as a bailout technique for large vessel intracranial occlusions
  1. Syed Uzair Ahmed,
  2. Jenna Mann,
  3. Jeremie Houde,
  4. Evan Barber,
  5. Michael E Kelly,
  6. Lissa Peeling
  1. Division of Neurosurgery and Department of Medical Imaging, Royal University Hospital, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
  1. Correspondence to Dr Lissa Peeling, Division of Neurosurgery and Department of Medical Imaging, Royal University Hospital, University of Saskatchewan, Saskatoon S7N 0W8, Canada; lissapeeling{at}gmail.com

Abstract

The Solitaire (Medtronic Inc, Mansfield, Massachusetts, USA) is a stentriever device for endovascular treatment of acute ischemic stroke. Temporary endovascular bypass and mechanical thrombectomy are well-described applications of this device. However, few reports of permanent stent placement have been published. We present a series of five cases in which the Solitaire stent was implanted to restore distal flow after failure of conventional mechanical thrombectomy. All patients presented with large vessel occlusions with thrombi that were resistant to retrieval or suction-aspiration. Immediately after implantation the patients were given a loading dose of abciximab and then transitioned to dual antiplatelet therapy within 24 hours. Our series suggests that permanent deployment of the Solitaire may be considered as a bailout technique in the treatment of cerebral large vessel occlusion. Long-term antiplatelet therapy is required after deployment.

  • stroke
  • stent
  • technique
  • thrombectomy

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Footnotes

  • Contributors SUA, JM, JH, EB participated in the acquisition of data, interpretation and analysis of data, writing of the manuscript, editing of manuscript and agree to be accountable for the integrity of the work. MEK, LP participated in the conception of the manuscript, acquisition of data, interpretation and analysis of data, writing of the manuscript, editing of manuscript, and agree to be accountable for the integrity of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests MEK: consultant, Medtronic; LP: consultant, Medtronic.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The authors are willing to share de-identified participant data acquired during the case series preparation with any one who wishes to access the data. Data will be available immediately after publication with no end date. All available anonymized data have been published in this manuscript, with the exception of radiological imaging. Requests should be submitted to lissa.peeling@usask.ca.

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