title: Critical use of balloon angioplasty after recanalization failure with retrievable stent in acute cerebral artery occlusion.
abstract: OBJECTIVE
  Sudden major cerebral artery occlusion often resists recanalization with currently available techniques or can results in massive symptomatic intracranial hemorrhage (sICH) after thrombolytic therapy. The purpose of this study was to examine mechanical recanalization with a retrievable self-expanding stent and balloon in acute intracranial artery occlusions.
  
  
  METHODS
  Twenty-eight consecutive patients with acute intracranial artery occlusions were treated with a Solitaire retrievable stent. Balloon angioplasty was added if successful recanalization was not achieved after stent retrieval. The angiographic outcome was assessed by Thrombolysis in Cerebral Infarction (TICI) and the clinical outcomes were assessed by the National Institutes of Health Stroke Scale (NIHSS) and the modified Rankin Scale (mRS).
  
  
  RESULTS
  At baseline, mean age was 69.4 years and mean initial NIHSS score was 12.5. A recanalization to TICI 2 or 3 was achieved in 24 patients (85%) after stent retrieval. Successful recanalization was achieved after additional balloon angioplasty in 4 patients. At 90-day follow-up, 24 patients (85%) had a NIHSS improvement of ≥4 and 17 patients (60%) had a good outcome (mRS ≤2). Although there was sICH, there was one death associated with the procedure.
  
  
  CONCLUSIONS
  Mechanical thromboembolectomy with a retrievable stent followed by additional balloon angioplasty is a safe and effective first-line therapy for acute intracranial artery occlusions especially in case of unsuccessful recanalization after stent thrombectomy.
authors.affiliation: Department of Neurosurgery, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea.
authors.forename: Jae Hyun
authors.initials: JH
authors.lastname: Park
authors.forename: Sang Kyu
authors.initials: SK
authors.lastname: Park
authors.forename: Kyeong Sool
authors.initials: KS
authors.lastname: Jang
authors.forename: Dong Kyu
authors.initials: DK
authors.lastname: Jang
authors.forename: Young Min
authors.initials: YM
authors.lastname: Han
keywords: Acute cerebral artery occlusion; Balloon angioplasty; Mechanical recanalization; Retrievable stent
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