title: Initial experience with a self-expanding retrievable stent for recanalization of large vessel occlusions in acute ischemic stroke.
abstract: BACKGROUND
  Quicker recanalization results in better clinical outcomes in patients with acute ischemic strokes. We describe our experience with the use of a self-expanding, fully retrievable stent in acute intracranial occlusions.
  
  
  METHODS
  Patients who underwent intra-arterial procedures with a self-expanding, fully retrievable stent for acute ischemic strokes at our center in 2009 were included in this study. The primary outcome was recanalization [Thrombolysis in Myocardial Infarction (TIMI) grade 2/3] at end of procedure. Secondary endpoints were procedural interval times, incidence of vasospasm, rupture of vessels, device-related complications, groin complications, postprocedural intracerebral hemorrhage (ICH) on noncontrast CT, and all-cause mortality.
  
  
  RESULTS
  Fourteen patients (mean age 62.1 years, range 34-81 years; six males) were included in the study. Sites of occlusion are as follows: M1 middle cerebral artery (MCA, n = 8), M2 MCA (n = 1), proximal basilar artery (n = 1), and distal basilar artery (n = 4). An additional device or technique was used in 9 of 14 patients prior to the use of the retrievable stent. Twelve out of 14 (85.7%) achieved TIMI 2-3 recanalization with 4 of 14 (28.6%) achieving TIMI 3. Eight of 14 (57.1%) patients had modified Rankin Scale (0-2) at 3 months or discharge. ICH on follow-up CT was noted in 28.6% (4 of 14) of patients. All-cause mortality was 2 of 14 (14.3%).
  
  
  CONCLUSIONS
  Use of a novel self-expanding, fully retrievable stent resulted in fast and very high recanalization rates in acute ischemic strokes with intravascular occlusions.
authors.affiliation: Department of Clinical Neurosciences, University of Calgary, Calgary, Canada.
authors.forename: Bijoy K
authors.initials: BK
authors.lastname: Menon
authors.forename: Puneet
authors.initials: P
authors.lastname: Kochar
authors.forename: Andrew
authors.initials: A
authors.lastname: Ah-Seng
authors.forename: Mohammed A
authors.initials: MA
authors.lastname: Almekhlafi
authors.forename: Jayesh
authors.initials: J
authors.lastname: Modi
authors.forename: John H
authors.initials: JH
authors.lastname: Wong
authors.forename: Mark E
authors.initials: ME
authors.lastname: Hudon
authors.forename: Will
authors.initials: W
authors.lastname: Morrish
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Demchuk
authors.forename: Mayank
authors.initials: M
authors.lastname: Goyal
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000601:surgery*; D002533:Cerebral Angiography; D002548:Cerebral Revascularization / Q000295:instrumentation*; D020878:Device Removal; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D020521:Stroke / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome