Literature DB >> 20019113

Penumbra system: a novel mechanical thrombectomy device for large-vessel occlusions in acute stroke.

Z Kulcsár1, C Bonvin, V M Pereira, S Altrichter, H Yilmaz, K O Lövblad, R Sztajzel, D A Rüfenacht.   

Abstract

BACKGROUND AND
PURPOSE: Large IC artery occlusion is often resistant to recanalization. We present our initial experience with the PS.
MATERIALS AND METHODS: Presenting with a severe acute ischemic stroke, the first 27 consecutive patients were considered for thromboaspiration therapy and retrospective data base analysis. All patients received standard thrombectomy treatment as monotherapy or in combination with thrombolysis or IC stent placement. The primary end point was revascularization of the target vessel to grade 2 or 3 on the TICI scale. Secondary end points were improvement of >4 points on the NIHSS score at discharge and favorable outcome, and improvement in overall mortality at 3 months and in sICH- and procedure-related adverse events.
RESULTS: At baseline, the mean age was 66 +/- 14 years and the mean NIHSS score was 14 +/- 7. The anterior circulation was affected in 23 patients, and there were 4 basilar artery occlusions. Intracranial stent placement was performed in 4 patients. A recanalization to TICI 2 or 3 was achieved in 25 patients (93%). None of the patients developed sICH. At hospital discharge, 15 patients (56%) had an NIHSS improvement of >4 and 13 patients (48%) had an mRS score of <2 at 3 months. There was a significant correlation between complete vessel recanalization and favorable outcome. The all-cause mortality at 3 months was 11%.
CONCLUSIONS: The PS showed a high potential for recanalization of acute thromboembolic occlusions of the large cerebral arteries. Complete recanalization was strongly correlated with good clinical outcome.

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Year:  2009        PMID: 20019113      PMCID: PMC7964234          DOI: 10.3174/ajnr.A1924

Source DB:  PubMed          Journal:  AJNR Am J Neuroradiol        ISSN: 0195-6108            Impact factor:   3.825


  23 in total

1.  Collateral circulation is an independent radiological predictor of outcome after thrombolysis in acute ischaemic stroke.

Authors:  T Kucinski; C Koch; B Eckert; V Becker; H Krömer; C Heesen; U Grzyska; H J Freitag; J Röther; H Zeumer
Journal:  Neuroradiology       Date:  2002-12-07       Impact factor: 2.804

2.  Dynamic digitized cerebral parenchymography.

Authors:  J Théron; M Nelson; F Alachkar; D Mazia
Journal:  Neuroradiology       Date:  1992       Impact factor: 2.804

3.  Intra-arterial prourokinase for acute ischemic stroke. The PROACT II study: a randomized controlled trial. Prolyse in Acute Cerebral Thromboembolism.

Authors:  A Furlan; R Higashida; L Wechsler; M Gent; H Rowley; C Kase; M Pessin; A Ahuja; F Callahan; W M Clark; F Silver; F Rivera
Journal:  JAMA       Date:  1999-12-01       Impact factor: 56.272

4.  Safety and efficacy of mechanical embolectomy in acute ischemic stroke: results of the MERCI trial.

Authors:  Wade S Smith; Gene Sung; Sidney Starkman; Jeffrey L Saver; Chelsea S Kidwell; Y Pierre Gobin; Helmi L Lutsep; Gary M Nesbit; Thomas Grobelny; Marilyn M Rymer; Isaac E Silverman; Randall T Higashida; Ronald F Budzik; Michael P Marks
Journal:  Stroke       Date:  2005-06-16       Impact factor: 7.914

5.  Recanalization after thrombolysis in stroke patients: predictors and prognostic implications.

Authors:  A Zangerle; S Kiechl; M Spiegel; M Furtner; M Knoflach; P Werner; A Mair; G Wille; C Schmidauer; K Gautsch; T Gotwald; S Felber; W Poewe; J Willeit
Journal:  Neurology       Date:  2007-01-02       Impact factor: 9.910

6.  Tandem internal carotid artery/middle cerebral artery occlusion: an independent predictor of poor outcome after systemic thrombolysis.

Authors:  Marta Rubiera; Marc Ribo; Raquel Delgado-Mederos; Esteban Santamarina; Pilar Delgado; Joan Montaner; José Alvarez-Sabín; Carlos A Molina
Journal:  Stroke       Date:  2006-08-03       Impact factor: 7.914

7.  Trial design and reporting standards for intra-arterial cerebral thrombolysis for acute ischemic stroke.

Authors:  Randall T Higashida; Anthony J Furlan; Heidi Roberts; Thomas Tomsick; Buddy Connors; John Barr; William Dillon; Steven Warach; Joseph Broderick; Barbara Tilley; David Sacks
Journal:  Stroke       Date:  2003-07-17       Impact factor: 7.914

8.  Self-expanding stents for recanalization of acute cerebrovascular occlusions.

Authors:  E I Levy; R Mehta; R Gupta; R A Hanel; A J Chamczuk; D Fiorella; H H Woo; F C Albuquerque; T G Jovin; M B Horowitz; L N Hopkins
Journal:  AJNR Am J Neuroradiol       Date:  2007-05       Impact factor: 3.825

Review 9.  Intra-arterial thrombolysis in 24 consecutive patients with internal carotid artery T occlusions.

Authors:  M Arnold; K Nedeltchev; H P Mattle; T J Loher; F Stepper; G Schroth; C Brekenfeld; M Sturzenegger; L Remonda
Journal:  J Neurol Neurosurg Psychiatry       Date:  2003-06       Impact factor: 10.154

10.  Mechanical thrombectomy for acute ischemic stroke: final results of the Multi MERCI trial.

Authors:  Wade S Smith; Gene Sung; Jeffrey Saver; Ronald Budzik; Gary Duckwiler; David S Liebeskind; Helmi L Lutsep; Marilyn M Rymer; Randall T Higashida; Sidney Starkman; Y Pierre Gobin; Donald Frei; Thomas Grobelny; Frank Hellinger; Dan Huddle; Chelsea Kidwell; Walter Koroshetz; Michael Marks; Gary Nesbit; Isaac E Silverman
Journal:  Stroke       Date:  2008-02-28       Impact factor: 7.914

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  23 in total

1.  Initial experience with the Penumbra Stroke System for recanalization of large vessel occlusions in acute ischemic stroke.

Authors:  Bijoy K Menon; Michael D Hill; Muneer Eesa; Jayesh Modi; Rohit Bhatia; John Wong; Mark E Hudon; Will Morrish; Andrew M Demchuk; Mayank Goyal
Journal:  Neuroradiology       Date:  2010-06-08       Impact factor: 2.804

2.  Aspiration thrombectomy in concert with stent thrombectomy.

Authors:  Travis M Dumont; Maxim Mokin; Grant C Sorkin; Elad I Levy; Adnan H Siddiqui
Journal:  BMJ Case Rep       Date:  2013-07-12

Review 3.  Neurothrombectomy in the treatment of acute ischaemic stroke.

Authors:  Olav Jansen; Axel Rohr
Journal:  Nat Rev Neurol       Date:  2013-10-15       Impact factor: 42.937

4.  Sequential endovascular thrombectomy approach (SETA) to acute ischemic stroke: preliminary single-centre results and cost analysis.

Authors:  Alessio Comai; Thomas Haglmüller; Federica Ferro; Elisa Dall'Ora; Roberto Currò Dossi; Giampietro Bonatti
Journal:  Radiol Med       Date:  2015-02-06       Impact factor: 3.469

5.  Use of microcatheters for suction thrombectomy of acute distal occlusions.

Authors:  Hyon-Jo Kwon; Jong Wook Shin; Bum Soo Park; Jeong-Wook Lim; Hye Seon Jeong; Hee-Jung Song; Jei Kim; Hyeon-Song Koh
Journal:  Neuroradiology       Date:  2018-10-18       Impact factor: 2.804

Review 6.  What is meant by "TICI"?

Authors:  J E Fugate; A M Klunder; D F Kallmes
Journal:  AJNR Am J Neuroradiol       Date:  2013-04-11       Impact factor: 3.825

7.  Impact of retrievable stents on acute ischemic stroke treatment.

Authors:  C Brekenfeld; G Schroth; P Mordasini; U Fischer; M-L Mono; A Weck; M Arnold; M El-Koussy; J Gralla
Journal:  AJNR Am J Neuroradiol       Date:  2011-05-12       Impact factor: 3.825

8.  Sonothrombolysis: an emerging modality for the treatment of acute ischemic and hemorrhagic stroke.

Authors:  Azita Soltani; Wayne M Clark; Douglas R Hansmann
Journal:  Transl Stroke Res       Date:  2011-04-15       Impact factor: 6.829

9.  The role of hospitalists in the acute care of stroke patients.

Authors:  Alpesh Amin; David Likosky
Journal:  Curr Treat Options Cardiovasc Med       Date:  2010-03-30

10.  A meta-analysis of observational intra-arterial stroke therapy studies using the Merci device, Penumbra system, and retrievable stents.

Authors:  M A Almekhlafi; B K Menon; E A Freiheit; A M Demchuk; M Goyal
Journal:  AJNR Am J Neuroradiol       Date:  2012-07-26       Impact factor: 3.825

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