title: Temporary endovascular bypass:  rescue technique during mechanical thrombolysis.
abstract: BACKGROUND
  The goal of mechanical thrombolysis is to re-establish blood flow to a completely occluded artery in patients who fail intravenous thrombolytic therapy or who are outside the therapeutic window.
  
  
  OBJECTIVE
  We present our single-institution experience with the use of temporary, partial deployment of a self-expanding intracranial stent as a rescue technique for the treatment of acute stroke. The use of the Enterprise stent represents an off-label use of a humanitarian device exemption device.
  
  
  METHODS
  We performed a retrospective review of a prospective database of acute stroke patients treated with intra-arterial techniques at the Thomas Jefferson University Comprehensive Stroke Center from July 2009 to July 2010.
  
  
  RESULTS
  Seven patients were included, and we obtained a 100% recanalization rate to Thrombolysis in Myocardial Infarction grade 2 and 3 with a 28% asymptomatic hemorrhagic transformation. No device-related complications were encountered.
  
  
  CONCLUSIONS
  Temporary, partial deployment of a self-expanding intracranial stent as a rescue procedure is feasible, effective, and safe in the setting of endovascular intervention for acute stroke, although our experience is limited. This technique was used only as a rescue procedure when more established procedures failed.
authors.affiliation: Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA. Fernando.gonzalez@jefferson.edu
authors.forename: L Fernando
authors.initials: LF
authors.lastname: Gonzalez
authors.forename: Pascal
authors.initials: P
authors.lastname: Jabbour
authors.forename: Stavropoula
authors.initials: S
authors.lastname: Tjoumakaris
authors.forename: Sonia
authors.initials: S
authors.lastname: Teufack
authors.forename: David
authors.initials: D
authors.lastname: Gordon
authors.forename: Aaron
authors.initials: A
authors.lastname: Dumont
authors.forename: Robert
authors.initials: R
authors.lastname: Rosenwasser
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D061185:Mechanical Thrombolysis / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D020521:Stroke / Q000628:therapy*; D015912:Thrombolytic Therapy; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents