Journal of Korean Neurosurgical Society

  • 제53권2호
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  • Pages.77-82
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  • 2013
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Critical Use of Balloon Angioplasty after Recanalization Failure with Retrievable Stent in Acute Cerebral Artery Occlusion

  • Park, Jae Hyun (Department of Neurosurgery, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Park, Sang Kyu (Department of Neurosurgery, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Jang, Kyeong Sool (Department of Neurosurgery, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Jang, Dong Kyu (Department of Neurosurgery, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Han, Young Min (Department of Neurosurgery, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine)
  • 투고 : 2012.06.11
  • 심사 : 2013.02.04
  • 발행 : 2013.02.28
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초록

Objective : Sudden major cerebral artery occlusion often resists recanalization with currently available techniques or can results in massive symptomatic intracranial hemorrhage (sICH) after thrombolytic therapy. The purpose of this study was to examine mechanical recanalization with a retrievable self-expanding stent and balloon in acute intracranial artery occlusions. Methods : Twenty-eight consecutive patients with acute intracranial artery occlusions were treated with a Solitaire retrievable stent. Balloon angioplasty was added if successful recanalization was not achieved after stent retrieval. The angiographic outcome was assessed by Thrombolysis in Cerebral Infarction (TICI) and the clinical outcomes were assessed by the National Institutes of Health Stroke Scale (NIHSS) and the modified Rankin Scale (mRS). Results : At baseline, mean age was 69.4 years and mean initial NIHSS score was 12.5. A recanalization to TICI 2 or 3 was achieved in 24 patients (85%) after stent retrieval. Successful recanalization was achieved after additional balloon angioplasty in 4 patients. At 90-day follow-up, 24 patients (85%) had a NIHSS improvement of ${\geq}4$ and 17 patients (60%) had a good outcome (mRS ${\leq}2$). Although there was sICH, there was one death associated with the procedure. Conclusion : Mechanical thromboembolectomy with a retrievable stent followed by additional balloon angioplasty is a safe and effective first-line therapy for acute intracranial artery occlusions especially in case of unsuccessful recanalization after stent thrombectomy.

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피인용 문헌

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  2. Combined Use of Mechanical Thrombectomy with Angioplasty and Stenting for Acute Basilar Occlusions with Underlying Severe Intracranial Vertebrobasilar Stenosis: Preliminary Experience from a Single Ch vol.36, pp.10, 2015, https://doi.org/10.3174/ajnr.a4364
  3. Clinical Experience of Intra-Arterial Therapy in Patients with Acute Ischemic Stroke from a Single Institute vol.75, pp.5, 2016, https://doi.org/10.3348/jksr.2016.75.5.346
  4. Solitaire Stent in the Treatment of Acute Ischemic Stroke with Large Cerebral Artery Occlusion vol.8, pp.None, 2017, https://doi.org/10.1515/tnsci-2017-0015
  5. Adjuvant intra-arterial rt-PA injection at the initially deployed solitaire stent enhances the efficacy of mechanical thrombectomy in acute ischemic stroke vol.386, pp.None, 2018, https://doi.org/10.1016/j.jns.2018.01.012
  6. Clinical efficacy of tirofiban combined with a Solitaire stent in treating acute ischemic stroke vol.52, pp.10, 2019, https://doi.org/10.1590/1414-431x20198396
  7. Intracranial Rescue Stent Angioplasty After Stent-Retriever Thrombectomy : Multicenter Experience vol.29, pp.3, 2019, https://doi.org/10.1007/s00062-018-0690-4
  8. Permanent Stent Deployment for Preventing Vessel Reocclusion after Mechanical Thrombectomy in Acute Ischemic Stroke vol.6, pp.1, 2013, https://doi.org/10.21129/nerve.2020.6.1.7