title: Inadvertent Stent Retriever Detachment: A Multicenter Case Series and Review of Device Experience FDA Reports.
abstract: Mechanical thrombectomy using retrievable stents or stent retriever devices has become the mainstay of intra-arterial therapy for acute ischemic stroke. The recent publication of a series of positive trials supporting intra-arterial therapy as standard of care for the treatment of large vessel occlusion will likely further increase stent retriever use. Rarely, premature stent detachment during thrombectomy may be encountered. In our multicenter case series, we found a rate of detachment of less than 1% (n = 7/1,067), and all were first-generation Solitaire FR devices. A review of the US Food and Drug Administration database of device experience yielded 90 individual adverse reports of detachment. There were 82, 1 and 7 detachments of Solitaire FR (first generation), Solitaire FR2 (second generation) and Trevo devices, respectively. We conclude with a brief overview of the technical and procedural considerations which may be helpful in avoiding this rare complication.
authors.affiliation: SUNY Upstate Medical University, Syracuse, N.Y., USA.
authors.forename: Hesham
authors.initials: H
authors.lastname: Masoud
authors.affiliation: Boston University School of Medicine, Boston, Mass., USA.
authors.forename: Thanh N
authors.initials: TN
authors.lastname: Nguyen
authors.affiliation: University of Missouri at Kansas City, St. Luke's Health System, Kansas City, Kans., USA.
authors.forename: Coleman O
authors.initials: CO
authors.lastname: Martin
authors.affiliation: University of Missouri at Kansas City, St. Luke's Health System, Kansas City, Kans., USA.
authors.forename: William E
authors.initials: WE
authors.lastname: Holloway
authors.affiliation: University of Miami Miller School of Medicine, Miami, Fla., USA.
authors.forename: Sudheer
authors.initials: S
authors.lastname: Ambekar
authors.affiliation: University of Miami Miller School of Medicine, Miami, Fla., USA.
authors.forename: Dileep R
authors.initials: DR
authors.lastname: Yavagal
authors.affiliation: Emory University School of Medicine, Atlanta, Ga., USA.
authors.forename: Diogo C
authors.initials: DC
authors.lastname: Haussen
authors.affiliation: Emory University School of Medicine, Atlanta, Ga., USA.
authors.forename: Raul
authors.initials: R
authors.lastname: Nogueira
authors.affiliation: University of Massachusetts, Worcester, Mass., USA.
authors.forename: Diego J
authors.initials: DJ
authors.lastname: Lozano
authors.affiliation: University of Massachusetts, Worcester, Mass., USA.
authors.forename: Ajit
authors.initials: A
authors.lastname: Puri
authors.affiliation: University of Ottawa, Ottawa, Ont. Montreal, Ont., Canada.
authors.forename: Ayman
authors.initials: A
authors.lastname: Quateen
authors.affiliation: University of Ottawa, Ottawa, Ont. Montreal, Ont., Canada.
authors.forename: Daniela
authors.initials: D
authors.lastname: Iancu
authors.affiliation: University of Kansas School of Medicine, Kansas City, Kans., USA.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Abraham
authors.affiliation: Rush University Medical Center, Chicago, Ill., USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Chen
authors.affiliation: University Specialty Clinics, University of South Carolina, Columbia, S.C., USA.
authors.forename: Sonal
authors.initials: S
authors.lastname: Mehta
authors.affiliation: Alexian Brothers Medical Center, Elk Grove Village, Dallas, Tex., USA.
authors.forename: Tim
authors.initials: T
authors.lastname: Malisch
authors.affiliation: Alexian Brothers Medical Center, Elk Grove Village, Dallas, Tex., USA.
authors.forename: Franklin
authors.initials: F
authors.lastname: Marden
authors.affiliation: UT Southwestern Medical Center, Dallas, Tex., USA.
authors.forename: Robin
authors.initials: R
authors.lastname: Novakovic
authors.affiliation: Centre Hospitalier de l'Université de Montréal, Montreal, Ont., Canada.
authors.forename: Daniel
authors.initials: D
authors.lastname: Roy
authors.affiliation: Centre Hospitalier de l'Université de Montréal, Montreal, Ont., Canada.
authors.forename: Alain
authors.initials: A
authors.lastname: Weill
authors.affiliation: Boston University School of Medicine, Boston, Mass., USA.
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Norbash
keywords: Detachment; Mechanical thrombectomy; Solitaire FR device; Stent retriever; Stroke; Trevo device