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Intraarterial suction thrombectomy in acute stroke
Helmi L Lutsep1, Wayne M Clark, Gary M Nesbit
1Oregon Stroke Center, Oregon Health Sciences University, Portland 97201, USA.
Insights
Intra-arterial suction thrombectomy safely and effectively restored blood flow in acute stroke patients with internal carotid artery thrombus. This minimally invasive procedure significantly improved neurological outcomes within hours of stroke onset.
Area of Science:
- Neurology
- Interventional Neuroradiology
- Vascular Surgery
Background:
- Acute ischemic stroke due to internal carotid artery thrombus presents a critical therapeutic challenge.
- Thrombolysis in Myocardial Infarction (TIMI) 0-1 flow indicates severely reduced or absent blood flow, necessitating urgent intervention.
Observation:
- Three patients with acute stroke and internal carotid artery thrombus underwent intra-arterial (IA) suction thrombectomy.
- The procedure involved catheterization and aspiration of thrombus using a 60-mL syringe, performed a mean of 4.2 hours post-stroke onset.
Findings:
- Successful restoration of Thrombolysis in Myocardial Infarction (TIMI) grade 3 flow was achieved in all treated patients.
- A significant median decrease in National Institutes of Health Stroke Scale (NIHSS) score from 22 to 4 was observed at 3 months post-procedure.
Implications:
- IA suction thrombectomy demonstrates safety and feasibility as a treatment option for acute internal carotid artery thrombus.
- This technique offers a promising minimally invasive approach to improve functional outcomes in acute stroke patients.
Abstract:
Three patients with internal carotid artery thrombus and thrombolysis in myocardial infarction (TIMI) 0-1 flow were treated by using intraarterial (IA) suction thrombectomy a mean of 4.2 hours after stroke onset. After catheterization with a 7F guide-catheter, thrombus was aspirated by using a 60-mL syringe. TIMI flow improved to 3 in all patients. The median National Institutes of Health Stroke Scale score decreased from 22 (range, 12-23) to 4 (range, 2-22) at 3 months. IA suction thrombectomy may be safe and feasible in patients with acute stroke.