title: Recanalization of large intracranial vessels using the penumbra system: a single-center experience.
abstract: OBJECTIVE
  The PS is an innovative mechanical device designed to recanalize large-vessel occlusions by thrombus aspiration. The purpose of this study was to evaluate the effectiveness and neurologic outcome of patients treated with the PS in the setting of acute ischemic stroke.
  
  
  METHODS
  A total of 91 patients with acute ischemic stroke due to large-vessel occlusion were treated with the PS and were included in our retrospective study. In 14 patients, only the PS was used for treatment; in 77 patients, mechanical recanalization was combined with IA and/or IV thrombolysis. Outcome was measured by using the mRS; recanalization was assessed with the TICI score.
  
  
  RESULTS
  Mean patient age was 62 ± 19.4 years; the average NIHSS score at hospital admission was 17. Successful recanalization was achieved in 77% of patients. Median time from arterial puncture to recanalization was 49 minutes (quartiles, 31-86 minutes). At follow-up, 36% of the patients showed an NIHSS improvement of ≥10%, and 34% of the patients with an anterior circulation occlusion had an mRS score of ≤2, whereas only 7% of the patients with a posterior occlusion had a favorable outcome at follow-up. In total, 20 patients died during hospitalization; none of these deaths were device-related.
  
  
  CONCLUSIONS
  In this study, the PS was an effective device for mechanical recanalization. Successful recanalization with the PS was associated with significant improvement of functional outcome in patients experiencing ischemic stroke secondary to anterior circulation occlusions.
authors.affiliation: Department of Neuroradiology, University Medicine Goettingen, Goettingen, Germany. m.psychogios@med.uni-goettingen.de
authors.forename: M-N
authors.initials: MN
authors.lastname: Psychogios
authors.forename: A
authors.initials: A
authors.lastname: Kreusch
authors.forename: K
authors.initials: K
authors.lastname: Wasser
authors.forename: A
authors.initials: A
authors.lastname: Mohr
authors.forename: K
authors.initials: K
authors.lastname: Gröschel
authors.forename: M
authors.initials: M
authors.lastname: Knauth
mesh_terms: D000328:Adult; D000368:Aged; D002533:Cerebral Angiography; D002560:Cerebrovascular Circulation; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D020767:Intracranial Thrombosis / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D061185:Mechanical Thrombolysis / Q000295:instrumentation*; D008875:Middle Aged; D020521:Stroke / Q000000981:diagnostic imaging / Q000209:etiology; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator