Primary mechanical thrombectomy for acute occlusions of cerebral arteries

Zander T, Vicente S, García de Casasola C, Aznárez J, Maynar M

Cerebral ischemia due to occlusion of the principal intracranial arteries is a significant cause of morbidity and mortality. New devices for mechanical thrombectomy can facilitate rapid extraction of the thrombus. This paper describes the results of primary mechanical thrombectomy with the Solitaire revascularization device without intravenous fibrinolysis.

From January 2010 to April 2013, 24 patients with occlusions of the main intracerebral arteries were treated by primary thrombectomy. The mean (SD) time elapsed from onset of symptoms until revascularization was 268 (11.3) minutes (range, 143–486 minutes). Revascularization was achieved in 19 patients (79.2%) within a punctureto- revascularization time of 63.9 (35.5) minutes. The mean score on the National Institute of Health Stroke Scale on admission was 21 (7.5) (range, 7–38). A score on the modified Rankin scale of 2 or lower was recorded for 15 patients (62.5%) on discharge and for 13 patients at 3 months. Three patients (12.5%) died from cerebral hemorrhage or infarct. It can be concluded that after ischemic stroke from occlusions of the main cerebral arteries, about 2 out of 3 of our patients benefited from primary mechanical extraction without intravenous fibrinolysis and had no or minimal disability on discharge.

Aznárez J, García de Casasola C, Maynar M, Vicente S, Zander T