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Clinical Neuroradiology
Published in: Clinical Neuroradiology 1/2016

Open Access 01-03-2016 | Original Article

The pREset Stent Retriever for Endovascular Treatment of Stroke Caused by MCA Occlusion: Safety and Clinical Outcome

Authors: B. J. Schwaiger, MD, F. Kober, A. S. Gersing, MD, J. F. Kleine, MD, S. Wunderlich, MD, C. Zimmer, MD, H. Poppert, MD, S. Prothmann, MD

Published in: Clinical Neuroradiology | Issue 1/2016

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Abstract

Purpose

The purpose of this study was to analyze the safety and efficacy of the pREset device, a stent retriever system, for endovascular mechanical thrombectomy (MT) in acute ischemic stroke (AIS) after middle cerebral artery (MCA) occlusion.

Methods

Retrospectively, 48 consecutive patients (mean age ± standard deviation, 71.0 ± 11.9 years; 24 women) treated for acute MCA occlusion using pREset solely or in combination with other MT devices were identified. Recanalization success was evaluated using the modified thrombolysis in cerebral infarction score (TICI), and complications were detected by 24-h follow-up computed tomography or magnetic resonance imaging. MCA anatomy was assessed in angiograms. Clinical outcome was evaluated with National Institutes of Health Stroke Scale (NIHSS) score at admission and discharge, and modified Rankin scale (mRS) score at discharge and follow-up.

Results

Successful recanalization (TICI 2b/3) was achieved in 39 patients (81.3 %). Rate of procedure-related complications was 8.3 %. In four patients, a subarachnoid hemorrhage occurred (8.3 %), and parenchymal hematoma was detected in four patients (8.3 %). None of those events was associated with clinical deterioration. MCA curvature significantly influenced recanalization success (P < 0.005).
Successful recanalization correlated significantly with lower NIHSS scores and favorable clinical outcome (mRS score 0–2) at discharge (P < 0.05). Mortality within 90 days was significantly lower in patients with TICI 2b/3 (P < 0.005).

Conclusions

High recanalization rates, low complication rates, and a significantly improved outcome after successful recanalization strongly suggest that MT with pREset is an adequate therapy for AIS after MCA occlusion. Vessel curvature is a significant determining factor for recanalization success.
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Metadata
Title
The pREset Stent Retriever for Endovascular Treatment of Stroke Caused by MCA Occlusion: Safety and Clinical Outcome
Authors
B. J. Schwaiger, MD
F. Kober
A. S. Gersing, MD
J. F. Kleine, MD
S. Wunderlich, MD
C. Zimmer, MD
H. Poppert, MD
S. Prothmann, MD
Publication date
01-03-2016
Publisher
Springer Berlin Heidelberg
Published in
Clinical Neuroradiology / Issue 1/2016
Print ISSN: 1869-1439
Electronic ISSN: 1869-1447
DOI
https://doi.org/10.1007/s00062-014-0329-z

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