Safety and efficacy of mechanical thrombectomy with Solitaire in patients with acute ischemic stroke

Abstract

Background Stroke is the third most common cause of death. Ischemic stroke accounts for 87% of all strokes. The standard treatment for acute ischemic stroke (AIS) is IV recombinant tissue plasminogen activator for patients who can reach the hospital with in 4.5 h. A rapid and complete recanalization is a major factor in good clinical outcomes in the treatment of acute cerebral ischemia. Stent-based recanalization techniques are increasingly used in stroke caused by large vessel occlusion, with promising results. Objective To evaluate the safety and efficacy of Solitaire stent retriever in recanalizing cerebral vessels in patients with AIS. Materials and Methods We treated 16 patients of AIS with a mean age of 52.25 years, ranging from 16 to 76 years with Solitaire clot retrieval system from September 2011 to March 2013 at our stroke center. The anterior circulation strokes were treated within 6 h of stroke onset and the posterior circulation strokes were treated up to 24 h of stroke onset. Patients with intracerebral bleed and established large acute infarcts were excluded. Results Out of the 16 patients of AIS treated with Solitaire clot retrieval system, good recanalization (thrombolysis in cerebral infarction 2 [TICI 2] and TICI 3) was achieved in 14/16 patients (87.5%) and no recanalization achieved in 2/16 (12.5%) patients. Clinical outcome was good (modified Rankin score 2 or less) in 10 out of 16 patients (62.5%). Conclusion Mechanical clot retrieval with Solitaire appears to be safe and effective in acutely occluded large intracranial vessels.