title: Outcome of forced-suction thrombectomy in acute intracranial internal carotid occlusion.
abstract: OBJECTIVE
  Ischemic stroke from acute intracranial distal internal carotid artery (ICA) occlusion usually carries a poor prognosis. Despite the intra-arterial revascularization therapies, the results are still unsatisfactory. The aim of this study was to compare the outcomes between two endovascular techniques, the modified Penumbra System (mPS) and mechanical clot disruption (MCD), and to confirm the influence of recanalization on the outcomes.
  
  
  METHODS
  In a retrospective review of 39 consecutive cases of acute distal ICA occlusion, the recanalization rates and functional outcomes at 3 months of the two intra-arterial techniques during two consecutive periods (May 2006 to February 2009: MCD technique (n=19) vs March 2009 to August 2010: mPS technique (n=20)) were compared. Univariate and multivariate analyses were performed to determine the predictors of a favorable functional outcome.
  
  
  RESULTS
  The rate of successful recanalization (Thrombolysis In Cerebral Infarction score 2 or 3) was significantly higher in the mPS group than in the MCD group (85% (17/20) vs 32% (6/19); p=0.001). Favorable outcomes at 3 months (modified Rankin Scale score 0-2) were achieved in 9/20 and 3/19 in the mPS and MCD groups, respectively (45% vs 16%; p=0.048). Binary logistic regression analysis showed that younger age and successful recanalization were independent predictors of a favorable functional outcome.
  
  
  CONCLUSIONS
  Forced-suction thrombectomy using the mPS technique may be a viable option for acute distal ICA occlusion and could result in more successful recanalization and a more positive clinical outcome.
authors.affiliation: Department of Neurology, Kyungpook National University Hospital, Daegu, Republic of Korea. yangha.hwang@gmail.com
authors.forename: Yang-Ha
authors.initials: YH
authors.lastname: Hwang
authors.forename: Dong-Hun
authors.initials: DH
authors.lastname: Kang
authors.forename: Yong-Won
authors.initials: YW
authors.lastname: Kim
authors.forename: Yong-Sun
authors.initials: YS
authors.lastname: Kim
authors.forename: Sung-Pa
authors.initials: SP
authors.lastname: Park
authors.forename: Chung-Kyu
authors.initials: CK
authors.lastname: Suh
mesh_terms: D000368:Aged; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D012042:Registries; D012189:Retrospective Studies; D020521:Stroke / Q000000981:diagnostic imaging / Q000601:surgery*; D013396:Suction / Q000379:methods; D017131:Thrombectomy / Q000379:methods*; D016896:Treatment Outcome