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01.05.2019 | NEURORADIOLOGY

Single-center experience using the 3MAX or 4MAX reperfusion catheter for the treatment of acute ischemic stroke with distal arterial occlusions in patients not eligible for intravenous fibrinolysis

verfasst von: Daniele Giuseppe Romano, Tommaso Casseri, Sara Leonini, Rossana Tassi, Samuele Cioni, Ignazio Maria Vallone, Paola Gennari, Maurizio Acampa, Giuseppe Martini, Sandra Bracco

Erschienen in: La radiologia medica | Ausgabe 5/2019

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Abstract

Background

In acute stroke, distal cerebrovascular occlusions can be linked to severe clinical symptoms, and treatment by mechanical thrombectomy may have an important clinical impact. When intravenous fibrinolytic therapy is firmly contraindicated, it remains the only treatment option.

Methods

A total of 42 patients with isolated distal arterial occlusions and absolute contraindication for intravenous fibrinolytic therapy were retrospectively included. Mechanical thrombectomy was performed using Penumbra 4MAX or 3MAX aspiration catheters. When aspiration alone did not result in successful revascularization, a stent retriever was added.

Results

Direct thromboaspiration was the first treatment option in all patients. 16.7% of cases required the additional use of a stent retriever. A TICI score ≥ 2b reperfusion at the end of the procedure was obtained in 76.2% and a Rankin Score of 2 or less at 90 days in 45.7%. Two hemorrhagic complications were observed.

Conclusions

Direct thromboaspiration appears a safe technique in acute isolated distal arterial occlusions. In a cohort of patients with absolute contraindication for intravenous fibrinolytic therapy, a significant percentage achieved good revascularization.

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Titel: Single-center experience using the 3MAX or 4MAX reperfusion catheter for the treatment of acute ischemic stroke with distal arterial occlusions in patients not eligible for intravenous fibrinolysis
verfasst von: Daniele Giuseppe Romano
Tommaso Casseri
Sara Leonini
Rossana Tassi
Samuele Cioni
Ignazio Maria Vallone
Paola Gennari
Maurizio Acampa
Giuseppe Martini
Sandra Bracco
Publikationsdatum: 01.05.2019
Verlag: Springer Milan
Erschienen in: La radiologia medica / Ausgabe 5/2019
Print ISSN: 0033-8362
Elektronische ISSN: 1826-6983
DOI: https://doi.org/10.1007/s11547-018-0965-5

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Single-center experience using the 3MAX or 4MAX reperfusion catheter for the treatment of acute ischemic stroke with distal arterial occlusions in patients not eligible for intravenous fibrinolysis