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Published on: February 26, 2013
[Mechanical thrombectomy using Solitaire AB stent for acute middle cerebral artery occlusion with atrial
Xucheng Zhu1, Ya Peng2, Jinggang Xuan1
1Department of Neurosurgery, the Third Affiliated Hospital of Soochow University, Changzhou 213003, China.
Insights
Mechanical thrombectomy with the Solitaire AB stent is a safe and effective treatment for acute middle cerebral artery occlusion in patients with atrial fibrillation, achieving high recanalization rates.
Area of Science:
- Neurology
- Interventional Neurology
- Vascular Neurology
Background:
- Acute middle cerebral artery (MCA) occlusion is a leading cause of stroke.
- Atrial fibrillation is a common comorbidity associated with ischemic stroke.
- Endovascular mechanical thrombectomy has emerged as a critical treatment modality.
Purpose of the Study:
- To evaluate the safety and efficacy of the Solitaire AB stent for mechanical thrombectomy.
- To assess the endovascular management strategy for acute MCA occlusion in patients with atrial fibrillation.
Main Methods:
- A cohort of 40 patients with acute MCA occlusion and atrial fibrillation were treated with the Solitaire AB stent.
- Clinical outcomes were assessed using the National Institute of Health Stroke Scale (NIHSS) and Modified Rankin Scale (mRS).
- Recanalization was evaluated using the Thrombolysis in Cerebral Infarction (TICI) score.
Main Results:
- Successful recanalization (TICI 2b or 3) was achieved in 92.5% of patients (37/40).
- At 90 days, 47.5% of patients (19/40) had a good outcome (mRS 0-2).
- No procedure-related complications were reported; symptomatic hemorrhagic transformation occurred in 15% of patients.
Conclusions:
- Mechanical thrombectomy using the Solitaire AB stent is a safe and effective treatment for acute MCA occlusion in patients with atrial fibrillation.
- The procedure demonstrated high recanalization rates and acceptable safety profile.
- Further research may explore optimization of treatment times and patient selection.
Objective:
To investigate the endovascular management strategy of mechanical thrombectomy using Solitaire AB stent for acute middle cerebral artery occlusion with atrial fibrillation and assess the safety and efficacy.
Methods:
From June 2012 to Dec 2013, 40 patients of acute middle cerebral artery occlusion with atrial fibrillation admitted to our institutes were treated by Solitaire AB stent.Clinical status was evaluated by the score of National Institute of Health Stroke Scale (NIHSS) before and 72 hours after treatment, immediate scale of thrombolysis in cerebral infarction (TICI) after thrombectomy, the 90 d score of Modified Rankin Scale (mRS).The patients were classified into good result group (mRS≤2) and bad result group (mRS>2) according to the mRS score.
Results:
Out of 40 cases, there were 28 cases caused by cardiogenic embolism. Recanalization was successful (TICI score 2b or 3) in 37 out of 40 (92.5%). 90 d follow-up mRS was 0-2 in 19 of 40 patients (47.5%). 3-5 in 21 patients (52.5%). 5 patients died (12.5%).Symptomatic hemorrhagic transform developed in 6 patients (15%).No complications related to the Solitaire AB thrombectomy occurred.Mean time from symptom onset to recanalization (312±52 min vs 370±68 min, P<0.05) and initial NIHSS score (17.0±0.4 vs 18.6±0.4, P<0.05) were of significant difference between good result group and bad result group.
Conclusion:
These results confirm that mechanical thrombectomy using solitaire AB stent for acute middle cerebral artery occlusion with atrial fibrillation is safe and effective.
