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

Kulcsár, Zsolt; Bonvin, Christophe; Pereira, Vítor Mendes; Altrichter, S.; Yılmaz, Hasan; Lövblad, Karl-Olof; Sztajzel, Roman; Rüfenacht, Daniel A.

doi:10.3174/ajnr.a1924

Cited by 81 publications

(48 citation statements)

References 21 publications

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“…3,14,17 However, when we focus on the complete recanalization only, rates are only 40%-50% of all treated patients. 3,9,14,15,17 Considering that these reports mainly focused on pure embolic ICA terminus occlusion rather than tandem occlusion, the expected complete recanalization rate for tandem occlusions (ICA terminus plus cervical ICA occlusion) would be even lower.…”

Section: Discussionmentioning

confidence: 99%

“…9,17,18 In a single-center experience with the Penumbra System, partial or complete reperfusion was achieved in 86% of ICA terminus occlusions, 15 and the Solitaire FR is expected to accomplish even better recanalization. 3,14,17 However, when we focus on the complete recanalization only, rates are only 40%-50% of all treated patients.…”

Section: Discussionmentioning

confidence: 99%

“…From the previous articles dealing with recanalization therapy of acute largevessel occlusions, mortality rates were 10%-50%, which suggests that our results were favorable. 3,9,14,15,17,18 The main limitation of our study derives from its retrospective nature and small patient number. However, to date, therapeutic strategies of cervical ICA/ICA terminus tandem occlusion have been mainly based on small case series.…”

Section: Discussionmentioning

confidence: 99%

“…3,9,14,15,17,19 Most cases of ICA terminus occlusions are caused by cardiogenic embolism (Fig. 1A), although some cases are due to cervical plaque rupture and secondary artery-to-artery large embolus with resultant tandem occlusion of the extracranial ICA and intracranial ICA terminus (Fig.…”

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confidence: 99%

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Emergent intracranial surgical embolectomy in conjunction with carotid endarterectomy for acute internal carotid artery terminus embolic occlusion and tandem occlusion of the cervical carotid artery due to plaque rupture

Hasegawa¹,

Inoue²,

Tamura³

et al. 2015

JNS

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A brupt intracranial large-vessel occlusion is associated with poor functional outcomes and a high mortality rate. The only possible solution is restoration of flow as soon as possible within a limited therapeutic time window. 1,13,18 Among these large vessel occlusions, the internal carotid artery (ICA) terminus occlusion is extremely difficult to manage.Acute ICA terminus occlusion responds poorly to intravenous administration of tissue plasminogen activator (tPA) due to its high clot burden; the recanalization rate is 4.4% in response to intravenous tPA alone and is 43.5% in response to intravenous tPA followed by additional endovascular treatment.1 Although new endovascular devices have accomplished better outcomes, the recanalization aBBReViatioNS ACoA = anterior communicating artery; CEA = carotid endarterectomy; DWI = diffusion-weighted imaging; ICA = internal carotid artery; MCA = middle cerebral artery; MRA = magnetic resonance angiography; mRS = modified Rankin Scale; NIHSS = National Institutes of Health Stroke Scale; PCoA = posterior communicating artery; TIMI = Thrombolysis In Myocardial Infarction; tPA = tissue plasminogen activator. SuBmitted December 25, 2013. accepted November 13, 2014. iNclude wheN citiNg Published online January 9, 2015; DOI: 10.3171/2014.11.JNS132855. diScloSuRe The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.Emergent intracranial surgical embolectomy in conjunction with carotid endarterectomy for acute internal carotid artery terminus embolic occlusion and tandem occlusion of the cervical carotid artery due to plaque rupture hirotaka hasegawa, md, tomohiro inoue, md, akira tamura, md, phd, and isamu Saito, md, phd Department of Neurosurgery, Fuji Brain Institute and Hospital, Shizuoka, Japan Acute internal carotid artery (ICA) terminus occlusion is associated with extremely poor functional outcomes or mortality, especially when it is caused by plaque rupture of the cervical ICA with engrafted thrombus that elongates and extends into the ICA terminus. The goal of this study was to evaluate the efficacy and safety of surgical embolectomy in conjunction with carotid endarterectomy (CEA) for acute ICA terminus occlusion associated with cervical plaque rupture resulting in tandem occlusion. A retrospective review of medical records was performed. Clinical and radiographic characteristics were evaluated, including details of surgical technique, recanalization grade, recanalization time, complications, modified Rankin Scale (mRS) score at 3 months, and National Institutes of Health Stroke Scale (NIHSS) score improvement at 1 month. Three patients (mean age 77.3 years; median presenting NIHSS Score 22, range 19-26) presented with abrupt tandem occlusion of the cervical ICA and ICA terminus and were selected for surgery after confirmation of embolic high-density signal at the ICA terminus on CT and diffusion-weighted imaging (DWI)/magnetic resonance angiography (MRA) mismatch. All patients under...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Emergent intracranial surgical embolectomy in conjunction with carotid endarterectomy for acute internal carotid artery terminus embolic occlusion and tandem occlusion of the cervical carotid artery due to plaque rupture

Hasegawa¹,

Inoue²,

Tamura³

et al. 2015

JNS

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“…Recanalization was reported according to TIMI in all studies except 3 [24][25][26] Table 2). Procedural complications and device-related technical issues were not always reported.…”

Section: Procedural Details and Outcomesmentioning

confidence: 99%

A Meta-Analysis of Observational Intra-Arterial Stroke Therapy Studies Using the Merci Device, Penumbra System, and Retrievable Stents

Almekhlafi

Menon²,

Freiheit

et al. 2012

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:The time from arterial puncture to successful recanalization is an important milestone toward timely recanalization. With the significant improvement in recanalization rates by using thrombectomy devices, procedural time to recanalization is becoming a determinant factor in choosing among available devices. We aimed to assess the impact of time to recanalization on the outcome of intra-arterial stroke therapies.

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Percutaneous aspiration of aortic valve vegetation in a patient with aortic valve endocarditis

Cioci,

Hutton,

et al. 2024

Clinical Case Reports

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Key Clinical MessagePercutaneous aspiration for debulking of vegetations in right‐sided infective endocarditis has been well‐described, however, this technique can be employed successfully for left‐sided vegetations in select high‐risk patients.AbstractWe report a case of percutaneous aspiration of an aortic valve vegetation in a patient with prosthetic valve endocarditis. This novel approach was selected after patient declined surgical intervention for an enlarging vegetation despite antibiotic therapy. The procedure was successful, resulting in the complete removal of solid vegetation without complications.

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

Cited by 81 publications

References 21 publications

Emergent intracranial surgical embolectomy in conjunction with carotid endarterectomy for acute internal carotid artery terminus embolic occlusion and tandem occlusion of the cervical carotid artery due to plaque rupture

Emergent intracranial surgical embolectomy in conjunction with carotid endarterectomy for acute internal carotid artery terminus embolic occlusion and tandem occlusion of the cervical carotid artery due to plaque rupture

A Meta-Analysis of Observational Intra-Arterial Stroke Therapy Studies Using the Merci Device, Penumbra System, and Retrievable Stents

Percutaneous aspiration of aortic valve vegetation in a patient with aortic valve endocarditis

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