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Updated: Apr 25, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
One-year MR angiographic and clinical follow-up after intracranial mechanical thrombectomy using a stent retriever
F Eugène1, J-Y Gauvrit1, J-C Ferré1
1From the Departments of Neuroradiology (F.E., J.-Y.G., J.-C.F., H.R.).
Insights
Mechanical endovascular thrombectomy using the Solitaire device can lead to delayed arterial abnormalities. A 1-year follow-up showed these were asymptomatic and associated with good clinical outcomes.
Area of Science:
- Neurology
- Interventional Radiology
- Vascular Imaging
Background:
- Mechanical endovascular thrombectomy is a key treatment for stroke.
- Potential arterial wall damage from thrombectomy requires further investigation.
Purpose of the Study:
- To assess 1-year MR angiographic and clinical outcomes in patients treated with Solitaire mechanical endovascular thrombectomy.
- To identify consequences of arterial wall damage post-thrombectomy.
Main Methods:
- Prospective 1-year follow-up of 39 stroke patients treated with Solitaire thrombectomy.
- 3T MR angiography (MRA) for intracranial and supra-aortic arteries.
- Clinical assessment using modified Rankin Scale (mRS) and SF-36 quality-of-life survey.
Main Results:
- 10 patients had intracranial artery abnormalities, including 5 delayed abnormalities (4 stenoses, 1 dilation) in 4 patients.
- 4 patients had pre-existing intracranial stenosis, and 2 had occlusions.
- Significant clinical improvement (P < .0001) observed by 1 year, with 62.5% achieving good outcomes.
Conclusions:
- Delayed asymptomatic arterial abnormalities can occur after Solitaire device thrombectomy.
- These findings highlight the importance of long-term vascular surveillance post-procedure.
Background And Purpose:
Little is known about the consequences of arterial wall damage that may be due to mechanical endovascular thrombectomy. Our aim was to perform 1-year MR angiographic and clinical follow-up of patients treated with mechanical endovascular thrombectomy using the Solitaire device.
Materials And Methods:
Patients with stroke treated between August 2010 and July 2012 were prospectively evaluated with a minimum follow-up of 1 year after mechanical endovascular thrombectomy. Angiographic follow-up was performed on a 3T MR imaging scanner and included intracranial artery TOF MRA and supra-aortic artery gadolinium-enhanced MRA. Images were assessed to detect arterial abnormalities (stenosis, occlusion, dilation) and were compared with the final post-mechanical endovascular thrombectomy run to differentiate delayed and pre-existing abnormalities. Clinical evaluation was performed with the mRS and the 36-Item Short-Form Health Survey questionnaire quality-of-life scale.
Results:
Thirty-nine patients were angiographically assessed at the mean term of 19 ± 4 months. MRA showed intracranial artery abnormalities in 10 patients, including 5 delayed intracranial artery abnormalities in 4 patients (4 stenoses and 1 dilation), 4 cases of pre-existing intracranial artery stenosis, and 2 occlusions. Pre-existing etiologic cervical artery stenosis or occlusion was observed in 2 patients. All these patients remained asymptomatic during the follow-up period. A significant clinical improvement was observed at 1-year follow-up in comparison with 3-month follow-up (P < .0001), with a good outcome achieved in 62.5% of patients and an acceptable quality of life restored.
Conclusions:
One-year follow-up identifies delayed asymptomatic arterial abnormalities in patients treated with the Solitaire device.
