Abstract
Purpose
Stent retrievers apply mechanical force to the intracranial vasculature. Our aim was to evaluate the safety and efficacy of the long Solitaire 4 × 40 mm stent retriever for large vessel occlusion in stroke patients.
Methods
We conducted a retrospective analysis of all patients treated for acute ischemic large vessel occlusion stroke with the Solitaire 2 FR 4 × 40 device between May and October 2016 at our institution. Patient-specific data at baseline and at discharge were documented. Reperfusion was graded with the thrombolysis in cerebral infarction (TICI) classification. Postinterventional angiograms and follow-up cross-sectional imaging were used to evaluate complications.
Results
TICI 2b/3 recanalization was achieved in 20 of 23 patients (87.0%), in 17 patients with the first retriever pass. NIHSS improved from a mean score at presentation of 16 (range 4–36) to 11 (range 0–41) at discharge. Mean mRS score at discharge was 3 (range 0–6) and 3 (range 0–6) at 90 days post-treatment. No infarcts in other territories were observed. One patient showed a (reversible) vasospasm in the postinterventional angiogram and another a small contrast extravasation in follow-up imaging.
Conclusion
The Solitaire 2 FR 4 × 40 stent retriever is a safe and efficient device for large vessel occlusion acute ischemic stroke with a high recanalization rate and a low peri- and postinterventional complication rate together with a good clinical outcome. Despite potentially higher friction and shearing forces, no increased incidence of visible damage to the vessel wall was observed.
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Jan Gralla: Global PI of STAR Study and Global PI of the SWIFT Direct trial, Consultant for Medtronic.
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For this type of study, formal consent is not required.
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Informed consent was obtained from all individual participants included in the study.
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Zibold, F., Mordasini, P., Mosimann, P. et al. Safety of the Solitaire 4 × 40 mm Stent Retriever in the Treatment of Ischemic Stroke. Cardiovasc Intervent Radiol 41, 49–54 (2018). https://doi.org/10.1007/s00270-017-1785-z
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DOI: https://doi.org/10.1007/s00270-017-1785-z