Penumbra System: A Novel Mechanical Thrombectomy Device for Large-Vessel Occlusions in Acute Stroke

Large IC artery occlusion is often resistant to recanalization. We present our initial experience with the PS. Presenting with a severe acute ischemic stroke, the first 27 consecutive patients were considered for thromboaspiration therapy and retrospective data base analysis. All patients received s...

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Bibliographic Details
Published in:American journal of neuroradiology : AJNR 2010-04, Vol.31 (4), p.628-633
Main Authors: KULCSAR, Z, BONVIN, C, PEREIRA, V. M, ALTRICHTER, S, YILMAZ, H, LÖVBLAD, K. O, SZTAJZEL, R, RÜFENACHT, D. A
Format: Article
Language:English
Subjects:
Acute Disease
Adult and adolescent clinical studies
Aged
Aged, 80 and over
Biological and medical sciences
Carotid Artery Thrombosis - diagnostic imaging
Carotid Artery Thrombosis - mortality
Carotid Artery Thrombosis - surgery
Catheterization - instrumentation
Cerebral Angiography
Combined Modality Therapy
Equipment Design
Female
Fibrinolytic Agents - therapeutic use
Humans
Image Processing, Computer-Assisted
Infarction, Middle Cerebral Artery - diagnostic imaging
Infarction, Middle Cerebral Artery - mortality
Infarction, Middle Cerebral Artery - surgery
Interventional
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Middle Aged
Nervous system
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Psychoses
Radiodiagnosis. Nmr imagery. Nmr spectrometry
Retrospective Studies
Schizophrenia
Stents
Suction - instrumentation
Surgical Instruments
Survival Rate
Thrombectomy - instrumentation
Thrombolytic Therapy
Tissue Plasminogen Activator - therapeutic use
Tomography, X-Ray Computed
Vertebrobasilar Insufficiency - diagnostic imaging
Vertebrobasilar Insufficiency - mortality
Vertebrobasilar Insufficiency - surgery
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Description
Summary:Large IC artery occlusion is often resistant to recanalization. We present our initial experience with the PS. Presenting with a severe acute ischemic stroke, the first 27 consecutive patients were considered for thromboaspiration therapy and retrospective data base analysis. All patients received standard thrombectomy treatment as monotherapy or in combination with thrombolysis or IC stent placement. The primary end point was revascularization of the target vessel to grade 2 or 3 on the TICI scale. Secondary end points were improvement of >4 points on the NIHSS score at discharge and favorable outcome, and improvement in overall mortality at 3 months and in sICH- and procedure-related adverse events. At baseline, the mean age was 66 +/- 14 years and the mean NIHSS score was 14 +/- 7. The anterior circulation was affected in 23 patients, and there were 4 basilar artery occlusions. Intracranial stent placement was performed in 4 patients. A recanalization to TICI 2 or 3 was achieved in 25 patients (93%). None of the patients developed sICH. At hospital discharge, 15 patients (56%) had an NIHSS improvement of >4 and 13 patients (48%) had an mRS score of
ISSN:0195-6108
1936-959X
DOI:10.3174/ajnr.a1924