Forbrig, Robert ORCID: 0000-0002-1054-1463, Lockau, Hannah, Flottmann, Fabian, Boeckh-Behrens, Tobias, Kabbasch, Christoph, Patzig, Maximilian, Mpotsaris, Anastasios ORCID: 0000-0002-1275-8164, Fiehler, Jens, Liebig, Thomas, Thomalla, Goetz, Onur, Oezguer A., Wunderlich, Silke, Kreiser, Kornelia ORCID: 0000-0002-6823-5493, Herzberg, Moriz, Wollenweber, Frank A., Prothmann, Sascha and Dorn, Franziska ORCID: 0000-0001-9093-8307 (2019). Intracranial Rescue Stent Angioplasty After Stent-Retriever Thrombectomy Multicenter Experience. Clin. Neuroradiol., 29 (3). S. 445 - 458. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1869-1447

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Abstract

Purpose Stent-retriever thrombectomy (SRT) for acute intracranial large artery occlusion (LAO) may not result in permanent recanalization in rare cases, e.g. due to an underlying stenosis or dissection. In this specific patient group, rescue stent angioplasty (RSA) may be the only treatment option to achieve permanent vessel patency and potentially a good clinical outcome. To date, the experience with RSA is limited. Methods In this retrospective analysis, interventional and clinical data of patients with acute intracranial LAO of the anterior and posterior circulation who underwent RSA after SRT due to an underlying lesion between 2012-2017 in four neurovascular centers were studied. Results In this study 34 patients (mean age 67 years) were included whereby 18 patients had anterior circulation LAO and 16 patients posterior circulation LAO. The SRT maneuver count ranged between 1 and 15 (median 2). Indications for RSA were an immediate re-occlusion in 25 (74%), and a persistent high-grade stenosis in 9 patients (26%). The RSA was technically feasible in 33 patients (97%). A mTICI 2b/3 result was obtained in 26 patients (76%). Median onset-to-recanalization time was 248min (range 80-650min). After 3 months 10/34 patients (29%) had a good clinical outcome (modified Rankin Scale, mRS 0-2). In detail, 4/18 patients (22%) with anterior circulation LAO and 6/16 patients (38%) with posterior circulation LAO were functionally independent. Conclusion The use of RSA can be considered for acute intracranial LAO in cases with immediate re-occlusion or high-grade stenosis after SRT alone.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Forbrig, RobertUNSPECIFIEDorcid.org/0000-0002-1054-1463UNSPECIFIED
Lockau, HannahUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Flottmann, FabianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Boeckh-Behrens, TobiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kabbasch, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Patzig, MaximilianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mpotsaris, AnastasiosUNSPECIFIEDorcid.org/0000-0002-1275-8164UNSPECIFIED
Fiehler, JensUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Liebig, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Thomalla, GoetzUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Onur, Oezguer A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wunderlich, SilkeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kreiser, KorneliaUNSPECIFIEDorcid.org/0000-0002-6823-5493UNSPECIFIED
Herzberg, MorizUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wollenweber, Frank A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Prothmann, SaschaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dorn, FranziskaUNSPECIFIEDorcid.org/0000-0001-9093-8307UNSPECIFIED
URN: urn:nbn:de:hbz:38-142573
DOI: 10.1007/s00062-018-0690-4
Journal or Publication Title: Clin. Neuroradiol.
Volume: 29
Number: 3
Page Range: S. 445 - 458
Date: 2019
Publisher: SPRINGER HEIDELBERG
Place of Publication: HEIDELBERG
ISSN: 1869-1447
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
ACUTE ISCHEMIC-STROKE; BASILAR ARTERY-OCCLUSION; MECHANICAL THROMBECTOMY; ENDOVASCULAR TREATMENT; SOLITAIRE DEVICE; SINGLE-CENTER; THERAPY; RECANALIZATION; RECOMMENDATIONS; ALTEPLASEMultiple languages
Clinical Neurology; Radiology, Nuclear Medicine & Medical ImagingMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/14257

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