title: Mechanical embolectomy for acute ischemic stroke in the anterior cerebral circulation: the Gothenburg experience during 2000-2011.
abstract: OBJECTIVE
  Intra-arterial treatment of proximal occlusions in the cerebral circulation have become an important tool in the management of acute ischemic stroke. Our goal was to evaluate the safety and efficacy of intra-arterial acute ischemic stroke treatment performed in our institution in consecutive patients with anterior circulation occlusion during 2000-2011.
  
  
  METHODS
  We identified, in our data base, 156 consecutive cases with anterior acute ischemic stroke treated intra-arterially during 2000-2011. Stroke severity was defined according to the National Institutes of Health Stroke Scale, the results of the procedure were defined according to the modified Thrombolysis in Cerebral Infarction score, and clinical outcome was defined according to the modified Rankin scale, with favorable outcome ≤2 at 90 days.
  
  
  RESULTS
  The mean admission NIHSS score was 19.4 (median, 20), with a mean time from stroke onset to groin puncture of 197 minutes (median, 171 minutes). The embolectomy tool of choice was the Amplatz GooseNeck snare (83%). Successful recanalization (modified TICI 2b +3) was seen in 74% of cases. A mRS ≤ 2 at 90 days was seen in 42% with a mortality rate of 17% and symptomatic intracerebral hemorrhage in 4%.
  
  
  CONCLUSIONS
  A high recanalization rate was obtained with the Amplatz GooseNeck snare without any device-related complications. Favorable outcome, mortality, and symptomatic intracerebral hemorrhage are comparable with results of newer embolectomy devices.
authors.affiliation: From the Departments of Interventional and Diagnostic Neuroradiology (A.R., V.V., K.S., G.W.) alexandros.rentzos@vgregion.se.
authors.forename: A
authors.initials: A
authors.lastname: Rentzos
authors.affiliation: Neurology (C.L., J.-E.K.), Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Lundqvist
authors.affiliation: Neurology (C.L., J.-E.K.), Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: J-E
authors.initials: JE
authors.lastname: Karlsson
authors.affiliation: From the Departments of Interventional and Diagnostic Neuroradiology (A.R., V.V., K.S., G.W.).
authors.forename: V
authors.initials: V
authors.lastname: Vilmarsson
authors.affiliation: From the Departments of Interventional and Diagnostic Neuroradiology (A.R., V.V., K.S., G.W.).
authors.forename: K
authors.initials: K
authors.lastname: Schnabel
authors.affiliation: From the Departments of Interventional and Diagnostic Neuroradiology (A.R., V.V., K.S., G.W.).
authors.forename: G
authors.initials: G
authors.lastname: Wikholm
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000601:surgery; D002543:Cerebral Hemorrhage / Q000453:epidemiology / Q000209:etiology; D017128:Embolectomy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D020521:Stroke / Q000601:surgery*; D016896:Treatment Outcome; D014481:United States