title: Mechanical thrombectomy with solitaire stent retrieval for acute ischemic stroke in a Brazilian population.
abstract: OBJECTIVE
  Large vessel occlusion in acute ischemic stroke is associated with low recanalization rates under intravenous thrombolysis. We evaluated the safety and efficacy of the Solitaire AB stent in treating acute ischemic stroke.
  
  
  METHODS
  Patients presenting with acute ischemic stroke were prospectively evaluated. The neurological outcomes were assessed using the National Institutes of Health Stroke Scale and the modified Rankin Scale. Time was recorded from the symptom onset to the recanalization and procedure time. Recanalization was assessed using the thrombolysis in cerebral infarction score.
  
  
  RESULTS
  Twenty-one patients were evaluated. The mean patient age was 65, and the National Institutes of Health Stroke Scale scores ranged from 7 to 28 (average 17 ± 6.36) at presentation. The vessel occlusions occurred in the middle cerebral artery (61.9%), distal internal carotid artery (14.3%), tandem carotid occlusion (14.3%), and basilarartery (9.5%). Primary thrombectomy, rescue treatment and a bridging approach represented 66.6%, 28.6%, and 4.8% of the performed procedures, respectively. The mean time from symptom onset to recanalization was 356.5 ± 107.8 minutes (range, 80-586 minutes). The mean procedure time was 60.4 ± 58.8 minutes (range, 14-240 minutes). The overall recanalization rate (thrombolysis in cerebral infarction scores of 3 or 2b) was 90.4%, and the symptomatic intracranial hemorrhage rate was 14.2%. The National Institutes of Health Stroke Scale scores at discharge ranged from 0 to 25 (average 6.9 ± 7). At three months, 61.9% of the patients had a modified Rankin Scale score of 0 to 2, with an overall mortality rate of 9.5%.
  
  
  CONCLUSIONS
  Intra-arterial thrombectomy with the Solitaire AB device appears to be safe and effective. Large randomized trials are necessary to confirm the benefits of this approach in acute ischemic stroke.
authors.affiliation: University of São Paulo, Medical School of Ribeirão Preto, Division of Interventional Neuroradiology, Ribeirão Preto/SP, Brazil.
authors.forename: Luis Henrique de
authors.initials: LH
authors.lastname: Castro-Afonso
authors.forename: Thiago Giansante
authors.initials: TG
authors.lastname: Abud
authors.forename: Octávio Marques
authors.initials: OM
authors.lastname: Pontes-Neto
authors.forename: Lucas Moretti
authors.initials: LM
authors.lastname: Monsignore
authors.forename: Guilherme Seizem
authors.initials: GS
authors.lastname: Nakiri
authors.forename: Pedro Telles
authors.initials: PT
authors.lastname: Cougo-Pinto
authors.forename: Lívia de
authors.initials: Ld
authors.lastname: Oliveira
authors.forename: Daniela dos
authors.initials: Dd
authors.lastname: Santos
authors.forename: Francisco A
authors.initials: FA
authors.lastname: Dias
authors.forename: Soraia Cabette Ramos
authors.initials: SC
authors.lastname: Fábio
authors.forename: Francisco Antônio
authors.initials: FA
authors.lastname: Coletto
authors.forename: Daniel Giansante
authors.initials: DG
authors.lastname: Abud
mesh_terms: D000368:Aged; D001938:Brazil; D020878:Device Removal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D061185:Mechanical Thrombolysis / Q000295:instrumentation / Q000379:methods*; D011446:Prospective Studies; D015607:Stents; D020521:Stroke / Q000000981:diagnostic imaging / Q000628:therapy*; D016896:Treatment Outcome; D014463:Ultrasonography