title: The pREset Stent Retriever for Endovascular Treatment of Stroke Caused by MCA Occlusion: Safety and Clinical Outcome.
abstract: OBJECTIVE
  The purpose of this study was to analyze the safety and efficacy of the pREset device, a stent retriever system, for endovascular mechanical thrombectomy (MT) in acute ischemic stroke (AIS) after middle cerebral artery (MCA) occlusion.
  
  
  METHODS
  Retrospectively, 48 consecutive patients (mean age ± standard deviation, 71.0 ± 11.9 years; 24 women) treated for acute MCA occlusion using pREset solely or in combination with other MT devices were identified. Recanalization success was evaluated using the modified thrombolysis in cerebral infarction score (TICI), and complications were detected by 24-h follow-up computed tomography or magnetic resonance imaging. MCA anatomy was assessed in angiograms. Clinical outcome was evaluated with National Institutes of Health Stroke Scale (NIHSS) score at admission and discharge, and modified Rankin scale (mRS) score at discharge and follow-up.
  
  
  RESULTS
  Successful recanalization (TICI 2b/3) was achieved in 39 patients (81.3 %). Rate of procedure-related complications was 8.3 %. In four patients, a subarachnoid hemorrhage occurred (8.3 %), and parenchymal hematoma was detected in four patients (8.3 %). None of those events was associated with clinical deterioration. MCA curvature significantly influenced recanalization success (P < 0.005). Successful recanalization correlated significantly with lower NIHSS scores and favorable clinical outcome (mRS score 0-2) at discharge (P < 0.05). Mortality within 90 days was significantly lower in patients with TICI 2b/3 (P < 0.005).
  
  
  CONCLUSIONS
  High recanalization rates, low complication rates, and a significantly improved outcome after successful recanalization strongly suggest that MT with pREset is an adequate therapy for AIS after MCA occlusion. Vessel curvature is a significant determining factor for recanalization success.
authors.affiliation: Abteilung für Neuroradiologie, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, Munich, Germany. benedikt.schwaiger@tum.de.
authors.forename: B J
authors.initials: BJ
authors.lastname: Schwaiger
authors.affiliation: Abteilung für Neuroradiologie, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Kober
authors.affiliation: Abteilung für Neuroradiologie, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
authors.forename: A S
authors.initials: AS
authors.lastname: Gersing
authors.affiliation: Abteilung für Neuroradiologie, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
authors.forename: J F
authors.initials: JF
authors.lastname: Kleine
authors.affiliation: Neurologische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Wunderlich
authors.affiliation: Abteilung für Neuroradiologie, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Zimmer
authors.affiliation: Neurologische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Poppert
authors.affiliation: Abteilung für Neuroradiologie, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Prothmann
mesh_terms: D000368:Aged; D002533:Cerebral Angiography; D002543:Cerebral Hemorrhage / Q000209:etiology* / Q000517:prevention & control; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D061185:Mechanical Thrombolysis / Q000009:adverse effects* / Q000295:instrumentation*; D015607:Stents / Q000009:adverse effects; D020521:Stroke / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome
keywords: MCA occlusion; Mechanical thrombectomy; Stent retriever; Stroke; Vessel anatomy; pREset
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