title: Impact of retrievable stents on acute ischemic stroke treatment.
abstract: OBJECTIVE
  Retrievable stents combine the high recanalization rate of stents and the capability of removing the thrombus offered by mechanical thrombectomy devices. We hypothesized that retrievable stents shorten time to recanalization in the multimodal approach for endovascular stroke treatment.
  
  
  METHODS
  Forty consecutive patients with acute ischemic stroke and undergoing endovascular therapy were included. Treatment included thromboaspiration, thrombus disruption, thrombolysis, PTA, and stent placement. In 17 patients, a retrievable stent was used (group A) in addition to multimodal therapy. The remaining 23 patients constituted group B. Baseline characteristics, occlusion sites, urokinase dose, recanalization rate, and time to recanalization were compared between the groups.
  
  
  RESULTS
  Median NIHSS scores were higher in group A compared with group B on admission (19 versus 12.5; P = .018) but were not significantly different at day 1 (14 versus 10; P = .6). Intra-arterial thrombolysis was used in significantly fewer patients of group A than group B (53% versus 87%, respectively; P = .017), and median urokinase dose was lower in group A than in group B (250,000 IU versus 700,000 IU; P = .006). Time to recanalization was significantly shorter in group A compared with group B (median time to recanalization 52.5 minutes versus 90 minutes, respectively; P = .001). Recanalization rate was higher in group A than group B (94% versus 78%; P = .17).
  
  
  CONCLUSIONS
  Addition of retrievable stents to the multimodal endovascular approach for acute ischemic stroke treatment significantly reduces time to recanalization and further increases the recanalization rate.
authors.affiliation: University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern, Switzerland. caspar.brekenfeld@insel.ch
authors.forename: C
authors.initials: C
authors.lastname: Brekenfeld
authors.forename: G
authors.initials: G
authors.lastname: Schroth
authors.forename: P
authors.initials: P
authors.lastname: Mordasini
authors.forename: U
authors.initials: U
authors.lastname: Fischer
authors.forename: M-L
authors.initials: ML
authors.lastname: Mono
authors.forename: A
authors.initials: A
authors.lastname: Weck
authors.forename: M
authors.initials: M
authors.lastname: Arnold
authors.forename: M
authors.initials: M
authors.lastname: El-Koussy
authors.forename: J
authors.initials: J
authors.lastname: Gralla
mesh_terms: D000208:Acute Disease; D000368:Aged; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D002533:Cerebral Angiography; D002548:Cerebral Revascularization / Q000295:instrumentation* / Q000379:methods* / Q000706:statistics & numerical data; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D020521:Stroke / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D017131:Thrombectomy / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D016896:Treatment Outcome