Self-Expanding Stent for Recanalization of Acute Embolic or Dissecting Intracranial Artery Occlusion

Abstract

BACKGROUND AND PURPOSE: Stent placement may be an effective and last resort method for recanalization of recalcitrant intracranial artery occlusion. The purpose of this study was to evaluate the safety and efficacy of a self-expanding stent for the recanalization of acute embolic or dissecting intracranial artery occlusion.

Mechanical Thrombectomy with a Self-Expanding Retrievable Intracranial Stent (Solitaire AB): Experience in 26 Patients with Acute Cerebral Artery Occlusion: Fig 1.

“…10 These few reports also included the use of the Enterprise stent (Cordis, Miami Lakes, Florida), with the added benefit of being able to remove the partially deployed device once recanalization had been established. 11,12 This approach was modified further, and a recent animal study (swine vessel occlusion model) reported using the fully retrievable Solitaire stent as a bypass and snare. 13 Bypass is, however, not plausible when the thrombus length exceeds that of the stent, and we believe that it is the snare capability of this intracranial stent that sets it aside as a potentially highly effective device for acute stroke treatment.…”

Comparison of the Incidence of Parenchymal Hematoma and Poor Outcome in Patients with Carotid Terminus Occlusion Treated with Intra-Arterial Urokinase Alone or with Combined IV rtPA and Intra-Arterial Urokinase

“…[27][28][29][30][31][32] Stent-assisted chemical treatment is also feasible, and the use of a lower dosage of chemicals is expected. 33 Our data were strengthened by a relatively homogeneous study cohort with IA thrombolytics without other IA mechanical or combined recanalization techniques. However, group comparison might possess low statistical power and independent predictors, for the occurrence of PH could not be achieved due to the small number of patients.…”

Thrombectomy Using Penumbra System for In-stent Reocclusion after Revascularization with Stent for Acute Stroke: A Case Report

“…However, acute occlusion of major intracranial arteries may be caused by embolic lesions that cannot be recanalized by the above devices as well as atherosclerotic lesions and arterial dissection. 6,9,10) In revascularization therapy for acute occlusion of major intracranial arteries, in which recanalization is a prognostic factor, stenting is an option to achieve recanalization. [3][4][5][6] In the patient presented here, the cause of vascular occlusion was unclear, but recanalization could not be achieved by treatments using stent retriever or balloon dilation but was achieved by stenting at the initial treatment.…”

“…6,9,10) In revascularization therapy for acute occlusion of major intracranial arteries, in which recanalization is a prognostic factor, stenting is an option to achieve recanalization. [3][4][5][6] In the patient presented here, the cause of vascular occlusion was unclear, but recanalization could not be achieved by treatments using stent retriever or balloon dilation but was achieved by stenting at the initial treatment. Recanalization by stenting is an effective measure, but there is concern over the possibility of in-stent occlusion after stenting in the acute period due to causes including an insufficient effect of antiplatelets.…”

“…1) In such cases, attempting recanalization by placing intracranial stents, such as the Enterprise Vascular Reconstruction Device (VRD; Cordis Neurovascular, Inc., Miami Lakes, FL, USA), is a treatment option. [3][4][5][6] However, there is a possibility of in-stent reocclusion after stenting in the acute period. In addition, discussion about the revascularization procedure for in-stent reocclusion remains insufficient.…”