Efficacy of mechanical thrombectomy with Penumbra System using Max series

Abstract

Background and Purpose: The Penumbra System (PS) is a mechanical thrombectomy device for recanalization of a large artery occlusion in acute stroke. The purpose of this study was to clarify the efficacy of PS with MAX system. Methods: We retrospectively reviewed 74 consecutive patients treated by PS at our institution between November 2011 and May 2014. We compared the Penumbra MAX series (MAX) with conventional Penumbra System (CPS) by examining the characteristics of treated patients, procedure contents, and angiographic and clinical outcomes. Results: MAX and CPS were performed in 32 and 42 patients, respectively. Baseline mean National Institutes of Health Stroke Score (NIHSS) was 20 in the MAX group and 18 in the CPS group. The recanalization rate was higher in the MAX group (88%) than in the CPS group (71%). Mean procedure time was shorter in the MAX group (67 min) than in the CPS group (114 min). Completion of the procedure with PS alone was more frequent in the MAX group (66%) than in the CPS group (36%). Symptomatic intracranial hemorrhage occurred only in one patient in the CPS group. The rate of favorable clinical outcome (mRS ≤ 2 at 3 months post-procedure) was 41% and 43% in MAX and CPS groups, respectively. Conclusions: Mechanical thrombectomy with MAX was effective for acute ischemic stroke. Use of MAX with PS increased the rate of recanalization and shortened the procedure time, although it did not improve clinical outcomes because patients baseline condition was poor.