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14.05.2018 | Original Article

Intracranial Rescue Stent Angioplasty After Stent-Retriever Thrombectomy

Multicenter Experience

verfasst von: Robert Forbrig, Hannah Lockau, Fabian Flottmann, Tobias Boeckh-Behrens, Christoph Kabbasch, Maximilian Patzig, Anastasios Mpotsaris, Jens Fiehler, Thomas Liebig, Goetz Thomalla, Oezguer A. Onur, Silke Wunderlich, Kornelia Kreiser, Moriz Herzberg, Frank A. Wollenweber, Sascha Prothmann, Franziska Dorn

Erschienen in: Clinical Neuroradiology | Ausgabe 3/2019

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Abstract

Purpose

Stent-retriever thrombectomy (SRT) for acute intracranial large artery occlusion (LAO) may not result in permanent recanalization in rare cases, e.g. due to an underlying stenosis or dissection. In this specific patient group, rescue stent angioplasty (RSA) may be the only treatment option to achieve permanent vessel patency and potentially a good clinical outcome. To date, the experience with RSA is limited.

Methods

In this retrospective analysis, interventional and clinical data of patients with acute intracranial LAO of the anterior and posterior circulation who underwent RSA after SRT due to an underlying lesion between 2012–2017 in four neurovascular centers were studied.

Results

In this study 34 patients (mean age 67 years) were included whereby 18 patients had anterior circulation LAO and 16 patients posterior circulation LAO. The SRT maneuver count ranged between 1 and 15 (median 2). Indications for RSA were an immediate re-occlusion in 25 (74%), and a persistent high-grade stenosis in 9 patients (26%). The RSA was technically feasible in 33 patients (97%). A mTICI 2b/3 result was obtained in 26 patients (76%). Median onset-to-recanalization time was 248 min (range 80–650 min). After 3 months 10/34 patients (29%) had a good clinical outcome (modified Rankin Scale, mRS 0–2). In detail, 4/18 patients (22%) with anterior circulation LAO and 6/16 patients (38%) with posterior circulation LAO were functionally independent.

Conclusion

The use of RSA can be considered for acute intracranial LAO in cases with immediate re-occlusion or high-grade stenosis after SRT alone.

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Titel: Intracranial Rescue Stent Angioplasty After Stent-Retriever Thrombectomy
Multicenter Experience
verfasst von: Robert Forbrig
Hannah Lockau
Fabian Flottmann
Tobias Boeckh-Behrens
Christoph Kabbasch
Maximilian Patzig
Anastasios Mpotsaris
Jens Fiehler
Thomas Liebig
Goetz Thomalla
Oezguer A. Onur
Silke Wunderlich
Kornelia Kreiser
Moriz Herzberg
Frank A. Wollenweber
Sascha Prothmann
Franziska Dorn
Publikationsdatum: 14.05.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Neuroradiology / Ausgabe 3/2019
Print ISSN: 1869-1439
Elektronische ISSN: 1869-1447
DOI: https://doi.org/10.1007/s00062-018-0690-4

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Intracranial Rescue Stent Angioplasty After Stent-Retriever Thrombectomy

Multicenter Experience

Abstract

Purpose

Methods

Results

Conclusion

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Purpose

Methods

Results

Conclusion

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