title: Mechanical recanalization with flow restoration in acute ischemic stroke: the ReFlow (mechanical recanalization with flow restoration in acute ischemic stroke) study.
abstract: OBJECTIVE
  This study sought to assess the feasibility and safety of a recently described technique of mechanical recanalization with the help of a stent-like device.
  
  
  BACKGROUND
  In the special group of acute stroke patients with an intracranial large vessel occlusion, intravenous tissue-type plasminogen activator on its own leads to a good clinical outcome (mRS ≤ 2) in only 15% to 25% of cases. The aforementioned technique of mechanical recanalization showed very promising clinical results.
  
  
  METHODS
  Forty patients presenting within 6 h from stroke symptom onset were enrolled. Mechanical recanalization was performed using a Solitaire FR revascularization device. The primary endpoint of the study was the clinical outcome rated with the help of the modified Rankin Scale (mRS) after 90 days.
  
  
  RESULTS
  Twenty-four patients (60%) showed a good clinical outcome (mRS ≤ 2) at 90 days. One symptomatic hemorrhage was detected on follow-up computed tomography. The death rate was 12.5% (5 patients). Successful recanalization (Thrombolysis In Cerebral Infarction score ≥ 2b) of the target vessel was achieved in 95% of the patients with a mean of 1.8 runs with the device.
  
  
  CONCLUSIONS
  The ReFlow (Mechanical Recanalization With Flow Restoration in Acute Ischemic Stroke) study shows that mechanical recanalization with flow restoration is highly effective in stroke patients with a large intracranial vessel occlusion presenting within 4.5 h after symptom onset. (Mechanical Recanalization With Flow Restoration in Acute Ischemic Stroke [ReFlow]; NCT01210729).
authors.affiliation: Clinic for Diagnostic and Interventional Neuroradiology, Saarland University Hospital, Homburg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Roth
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Reith
authors.forename: Silke
authors.initials: S
authors.lastname: Walter
authors.forename: Stefanie
authors.initials: S
authors.lastname: Behnke
authors.forename: Michael
authors.initials: M
authors.lastname: Kettner
authors.forename: Julio
authors.initials: J
authors.lastname: Viera
authors.forename: Umut
authors.initials: U
authors.lastname: Yilmaz
authors.forename: Maria
authors.initials: M
authors.lastname: Alexandrou
authors.forename: Maria
authors.initials: M
authors.lastname: Politi
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Kostopoulos
authors.forename: Heiko
authors.initials: H
authors.lastname: Körner
authors.forename: Christoph
authors.initials: C
authors.lastname: Krick
authors.forename: Anton
authors.initials: A
authors.lastname: Haass
authors.forename: Klaus
authors.initials: K
authors.lastname: Fassbender
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Papanagiotou
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D002560:Cerebrovascular Circulation; D004185:Disability Evaluation; D005240:Feasibility Studies; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D061185:Mechanical Thrombolysis / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011474:Prosthesis Design; D020127:Recovery of Function; D015607:Stents; D020521:Stroke / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome