title: Mechanical thrombectomy with the Solitaire AB device in large intracerebral artery occlusions.
abstract: BACKGROUND
  Mechanical thrombectomy has the potential to revolutionise the treatment of acute stroke. The Solitaire AB device is used for clot retrieval with unprecedented revascularisation rates being reported. Our aim is to report our experiences of the safety and efficacy of the Solitaire AB device in acute ischaemic stroke.
  
  
  METHODS
  A retrospective dual-centre study of 21 patients with acute ischaemic stroke who underwent mechanical thrombectomy with the Solitaire AB device between 1 October 2010 and 1 December 2011 was carried out. Using clinical data recovered from patients' case notes, we identified time intervals from groin puncture to recanalisation, revascularisation rates, procedural complications and neurological status before and after treatment (using the National Institutes of Health Stroke Scale (NIHSS) and modified Rankin scale (mRS) respectively).
  
  
  RESULTS
  Successful revascularisation, defined as Thrombosis in Cerebral Ischemia Grade 2 or 3, was achieved in 81% of cases. The mean NIHSS score at presentation was 18.5. The mean number of passes required to achieve recanalisation was 1.95 and the median duration of the procedure from groin puncture to recanalisation was 65 min. Procedural events included distal emboli (n = 2), arterial dissection (n = 1) and arterial perforation (n = 1).There were three cases of asymptomatic intracranial haemorrhage. Forty-eight per cent of patients achieved a good functional outcome at 3 months (mRS score ≤2). The mortality rate at 3 months was 19% (n = 4). There was no procedure-related mortality.
  
  
  CONCLUSIONS
  Mechanical thrombectomy with the Solitaire AB device is safe and achieves high rates of revascularisation in acute stroke with good clinical outcomes.
authors.affiliation: Neurological Intervention & Imaging Service of Western Australia (NIISWA), Sir Charles Gairdner Hospital, Perth, Western Australia, Australia. mccabej1@tcd.ie
authors.forename: John J
authors.initials: JJ
authors.lastname: McCabe
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Phillips
authors.forename: Con
authors.initials: C
authors.lastname: Phatouros
authors.forename: Tejinder
authors.initials: T
authors.lastname: Singh
authors.forename: David
authors.initials: D
authors.lastname: Blacker
authors.forename: Graeme J
authors.initials: GJ
authors.lastname: Hankey
authors.forename: William
authors.initials: W
authors.lastname: McAuliffe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D002539:Cerebral Arterial Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D020766:Intracranial Embolism / Q000000981:diagnostic imaging / Q000209:etiology* / Q000517:prevention & control; D008297:Male; D061185:Mechanical Thrombolysis / Q000009:adverse effects* / Q000295:instrumentation*; D008875:Middle Aged; D010291:Paresis / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome; D014904:Western Australia