title: The combined use of mechanical thrombectomy devices is feasible for treating acute carotid terminus occlusion.
abstract: BACKGROUND
  Mechanical thrombectomy devices have recently been developed and approved for recanalization of intracranial arterial occlusion. Here, we investigated the feasibility of combined stent-assisted and clot aspiration mechanical thrombectomy for effective recanalization of acute carotid terminus occlusion (CTO).
  
  
  METHODS
  Ten consecutive patients with acute ischemic stroke secondary to CTO who underwent intra-arterial (IA) treatment with both stent retrieval and negative-pressured clot aspiration systems were enrolled. Periprocedural and radiologic findings and clinical outcomes were evaluated.
  
  
  RESULTS
  The median age was 69 years (range, 47-86 years), and the median initial NIHSS score was 17.5 (range, 12-33). Mechanical thrombectomy was performed using a combination of the Solitaire stents and Penumbra system. Thrombolysis in cerebral ischemia [TICI] grade II-III was achieved in eight patients (80.0 %); complete recanalization of the CTO (TICI III) was achieved in three of those patients. Any type of intracranial hemorrhages occurred in four patients (40.0 %), but parenchymal hematoma type 2 was not observed. Four patients died within 3 months (40.0 %).
  
  
  CONCLUSIONS
  Combined mechanical thrombectomy treatment was effective for recanalization of acute CTO. The combination of Solitaire and Penumbra devices can be considered as a treatment option for CTO.
authors: Department of Neurology, Ajou University School of Medicine, Ajou University Medical Center, Suwon, South Korea. jinsoo22@gmail.com
authors: Jin Soo
authors: JS
authors: Lee
authors: Ji Man
authors: JM
authors: Hong
authors: Seong-Joon
authors: SJ
authors: Lee
authors: In Soo
authors: IS
authors: Joo
authors: Yong Cheol
authors: YC
authors: Lim
authors: Sun Yong
authors: SY
authors: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000601:surgery*; D002340:Carotid Artery Diseases / Q000601:surgery*; D002533:Cerebral Angiography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000601:surgery*; D017131:Thrombectomy / Q000295:instrumentation*; D016896:Treatment Outcome