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Stent Retriever Thrombectomy with Mindframe Capture LP in Isolated M2 Occlusions

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Abstract

Background and Purpose

Mechanical thrombectomy is an effective recanalization technique in acute ischemic stroke patients with large vessel occlusions; however, it is unclear to what extent stent retriever thrombectomy may be applicable to occlusions of smaller peripheral cerebral vessels. The outcome of patients with isolated M2 occlusions treated with the Mindframe Capture low profile (LP) stent retriever was reviewed.

Material and Methods

A retrospective review of prospectively collected data on all consecutive patients treated for isolated M2 occlusions between June 2013 and December 2017 using the Mindframe Capture LP was performed. Technical aspects of the recanalization procedure, recanalization rate, complication rate, and clinical outcome were analyzed.

Results

Mechanical thrombectomy with the Mindframe Capture LP was performed in 38 patients (median age 79 years) with an isolated M2 occlusion. The median National Institutes of Health Stroke Scale (NIHSS) score on admission was 7.5 (interquartile range, IQR 5–12) and successful reperfusion modified Thrombolysis in Cerebral Infarction (mTICI 2b or 3) was achieved in 28 patients (74%). A compensated/adjusted modified Rankin Scale (mRS) 0–2 at 3 months was observed in 65% when taking pre-stroke disability into account. Symptomatic intracranial hemorrhage (sICH) occurred in 1 patient (2.6%). Asymptomatic intracranial hemorrhage (aICH) was noted in 8 patients (21%) and a small subarachnoid hemorrhage (SAH) in the immediate vicinity of the target vessel was apparent in 8 patients (21%).

Conclusion

The Mindframe Capture LP is a technically effective thrombectomy device for the treatment of isolated M2 occlusions. The lower profile of the device is advantageous when targeting peripheral intracranial occlusions.

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Acknowledgements

We thank Susan Kaplan for editorial assistance during the preparation of the manuscript.

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Authors and Affiliations

  1. University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland

    Tomas Dobrocky, Sebastian Bellwald, Eike I. Piechowiak, Johannes Kaesmacher, Pascal J. Mosimann, Felix Zibold, Jan Gralla & Pasquale Mordasini

  2. Department of Neurology, Inselspital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland

    Sebastian Bellwald, Rebekka Kurmann, Johannes Kaesmacher, Simon Jung, Marcel Arnold & Urs Fischer

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  1. Tomas Dobrocky
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Corresponding author

Correspondence to Pasquale Mordasini.

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Conflict of interest

T. Dobrocky, S. Bellwald, R. Kurmann, E.I. Piechowiak, J. Kaesmacher, F. Zibold, S. Jung and P. Mordasini declare that they have no competing interests. P.J. Mosimann receives Swiss National Science Foundation (SNSF) grants for research on brain aneurysms  (SFNS Grant n° CRSII5_170992). M. Arnold has received speaker fees from Bayer, Boehringer Ingelheim, and Covidien, and scientific advisory board fees from Bayer, Boehringer Ingelheim, BMS, Pfizer, Covidien, Daichy Sankyo and Nestlé Health Science. U. Fischer: Swiss National Science Foundation (SNSF) research grants (SFNS Grant n° 32003B_169975); Global PI SWIFT DIRECT trial, consultant for Medtronic and Stryker. J. Gralla: Global PI of STAR and SWIFT DIRECT (Medtronic), consultancy; CEC member of the Promise Study (Penumbra), consultancy; Swiss National Science Foundation (SNSF) grants for MRI in stroke.

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Dobrocky, T., Bellwald, S., Kurmann, R. et al. Stent Retriever Thrombectomy with Mindframe Capture LP in Isolated M2 Occlusions. Clin Neuroradiol 30, 51–58 (2020). https://doi.org/10.1007/s00062-018-0739-4

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