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Stent-assisted Mechanical Recanalization for Treatment of Acute Intracerebral Artery Occlusion

Stent-assisted Mechanical Recanalization for Treatment of Acute Intracerebral Artery Occlusion. C. Roth ‡ , P. Papanagiotou ‡ , S. Wal ter @ , S.Behnke @ , C. Becker @ , W. Reith ‡. Department of Diagnostic and Inte rventio nal Neuroradiology ‡ Department of Ne urolog y @

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Stent-assisted Mechanical Recanalization for Treatment of Acute Intracerebral Artery Occlusion

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  1. Stent-assisted Mechanical Recanalization for Treatment of Acute Intracerebral Artery Occlusion C. Roth‡, P. Papanagiotou‡, S. Walter@, S.Behnke@, C. Becker@, W. Reith‡ Department of Diagnostic and Interventional Neuroradiology‡ Department of Neurology@ Saarland University Hospital, Homburg, Germany

  2. Recanalization rate ICH mRS 0-2 69.5% 36% 9.8% 81.6% 25% 11.2% 72.4% 37.9% 7% 100% 45% (mRS 0-1) 5%

  3. Stenting in acute stroke Advantages Disadvantages • Prompt flow-restoration • High recanalization rate • Fast recanalization • Aggressive anticoagulation • Thrombus is only pressed against the wall • In-Stent stenosis possible

  4. 22 patients October 2009- May 2010 Nov 2010

  5. Patients • 13/22 patients iv lysis • 10/22 patients ia lysis • Solitaire AB/FR

  6. angiographical outcome • TICI 2b or 3 in 20/22 patients 90.9% • Number of device runs 1.74(1-4) • Vasospasm 3/22 (13.6%) Stent-assisted Mechanical Recanalization for Treatment of Acute Intracerebral Artery Occlusion Roth C, Papanagiotou P, Reith W et al. Stroke, in press

  7. clinical outcome symptomatic ICH: 2/22 (9%) Stent-assisted Mechanical Recanalization for Treatment of Acute Intracerebral Artery Occlusion Roth C, Papanagiotou P, Reith W et al. Stroke, in press

  8. 12:58 M1 occlusion

  9. 13:06 Placement of the Solitaire device

  10. 13:06 Prompt flow restoration

  11. 13:08 Thrombus in stent mesh

  12. Thrombus from aspiration syringe

  13. 13:10 Angiographical outcome

  14. Aspirated thrombus & thrombus in device mesh 20/22 90.9% Stent-assisted Mechanical Recanalization for Treatment of Acute Intracerebral Artery Occlusion Roth C, Papanagiotou P, Reith W et al. Stroke, in press

  15. 69.5% 36% 9.8% 100% 45% (mRS 0-1) 5% 81.6% 25% 11.2% 90.9% 50% 9% Nov 2010 72.4% 37.9% 7% ICH recanalization mRS 0-2

  16. Saarland University Hospital, Homburg, Germany reflow.study@me.com Mechanical REcanalization with FLOW Restoration in Acute Ischemic StrokeReFlow Study • Monocentric Prospective Trial • 40 Patients • Primary endpoint: favourable clinical outcome at 30 and 90 days (mRS 0 to2) • Solitaire FR Recanalization Device

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