title: Primary stent retrieval for acute intracranial large artery occlusion due to atherosclerotic disease.
abstract: OBJECTIVE
  The goal of stent retriever-based thrombectomy is removal of embolic clots in patients with intracranial large artery occlusion. However, outcomes of stent retrieval may differ between acute arterial occlusions due to intracranial atherosclerotic disease (IAD) and those due to embolism. This case series describes the outcomes of stent retriever-based thrombectomy and rescue treatments in 9 patients with IAD-related occlusion.
  
  
  METHODS
  Among patients who underwent endovascular treatment for acute intracranial large artery occlusion, those in whom stent retrieval was attempted as first-line treatment were included in this review. IAD was defined as significant fixed focal stenosis at the occlusion site, which was evident on final angiographic assessment or observed during endovascular treatment.
  
  
  RESULTS
  Median number of stent retriever passes was 2 (range, 1-3), and temporary bypass was seen in all patients. Immediate partial recanalization (arterial occlusive lesion grade 2-3) was observed in 7 patients. Immediate modified thrombolysis in cerebral infarction grade 2b-3 was seen in 6 patients, but the lesions often required rescue treatment due to reocclusion or flow insufficiency. In terms of rescue treatments, angioplasty and intra-arterial tirofiban infusion seemed to be effective.
  
  
  CONCLUSIONS
  Our findings suggest that stent retrieval can effectively remove thrombi from stenotic lesions and achieve partial recanalization despite the tendency toward reocclusion in most patients with IAD-related occlusion. Further research into the use of rescue treatments, such as tirofiban infusion and angioplasty, is warranted.
authors.affiliation: Department of Neurology, School of Medicine, Ajou University Medical Center, Suwon, Korea.
authors.forename: Jin Soo
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Department of Neurology, School of Medicine, Ajou University Medical Center, Suwon, Korea.
authors.forename: Ji Man
authors.initials: JM
authors.lastname: Hong
authors.affiliation: Department of Neurology, School of Medicine, Ajou University Medical Center, Suwon, Korea.
authors.forename: Kyu Sun
authors.initials: KS
authors.lastname: Lee
authors.affiliation: Department of Neurology, School of Medicine, Ajou University Medical Center, Suwon, Korea.
authors.forename: Hong Il
authors.initials: HI
authors.lastname: Suh
authors.affiliation: Department of Radiology, School of Medicine, Ajou University Medical Center, Suwon, Korea.
authors.forename: Jin Wook
authors.initials: JW
authors.lastname: Choi
authors.affiliation: Department of Radiology, School of Medicine, Ajou University Medical Center, Suwon, Korea.
authors.forename: Sun Yong
authors.initials: SY
authors.lastname: Kim
keywords: Cerebral infarction; Intracranial arteriosclerosis; Intracranial embolism and thrombosis; Mechanical thrombolysis; Thrombectomy