title: Open Embolectomy of Large Vessel Occlusion in the Endovascular Era: Results of a 12-Year Single-Center Experience.
abstract: BACKGROUND
  Mechanical endovascular embolectomy using stent retrievers has gained popularity for treatment of large vessel occlusion in acute ischemic stroke. Use of open embolectomy as a direct surgical treatment has been limited, likely owing to the technical difficulty, therapeutic time window, and time-consuming procedure.
  
  
  METHODS
  We retrospectively reviewed clinical and radiographic records of patients who underwent open embolectomy for major artery occlusion at an acute stage. Clinical features, complications, and outcome of patients were analyzed.
  
  
  RESULTS
  From January 2004 to September 2016, 153 patients underwent 157 open embolectomies for major artery occlusion. Complete recanalization was achieved in 96.2% of patients. A favorable outcome was observed in 43.9%. Cerebral aneurysm along the occluded artery was observed in 11 patients with 12 aneurysms.
  
  
  CONCLUSIONS
  Open embolectomy resulted in a high complete recanalization rate with an acceptable safety profile. Open embolectomy is a safe and durable method of cerebral recanalization in patients with embolic stroke and can be considered as a potential treatment if endovascular embolectomy cannot be performed. The details of the occluded arteries presented here will be useful for endovascular surgeons to prevent complications.
authors.affiliation: Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan; Kobayashi Neurosurgical Hospital, Nagano, Japan. Electronic address: tetuyosi@shinshu-u.ac.jp.
authors.forename: Tetsuyoshi
authors.initials: T
authors.lastname: Horiuchi
authors.affiliation: Kobayashi Neurosurgical Hospital, Nagano, Japan.
authors.forename: Junpei
authors.initials: J
authors.lastname: Nitta
authors.affiliation: Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan; Kobayashi Neurosurgical Hospital, Nagano, Japan.
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Miyaoka
authors.affiliation: Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Alhusain
authors.initials: A
authors.lastname: Nagm
authors.affiliation: Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Tsutsumi
authors.affiliation: Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Ito
authors.affiliation: Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hongo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002533:Cerebral Angiography; D000072226:Computed Tomography Angiography; D017128:Embolectomy / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D023261:Glasgow Outcome Scale; D006801:Humans; D021621:Imaging, Three-Dimensional; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D020301:Vasospasm, Intracranial / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult
keywords: Embolectomy; Embolism; Ischemia; Surgery