BACKGROUND AND PURPOSE: Stent-retriever devices play an increasing role in the interventional treatment of acute stroke patients, because fast recanalization can be achieved. The purpose of this study was to evaluate the feasibility of stent-retriever recanalization in patients with wake-up stroke in the anterior circulation. MATERIALS AND METHODS: We retrospectively analyzed clinical and angiographic data of 19 consecutive patients with wake-up stroke who were treated with stent-retriever devices between 2009 and October 2011. Recanalization was assessed by using the Thrombolysis in Cerebral Infarction score. Clinical outcome was evaluated at discharge and after 90 days by using the modified Rankin Scale. RESULTS: Median NIHSS score at admission was 17 (IQR, 15-20). Before the procedure, the TICI score was 0 in 18 patients and 1 in 1 patient. Recanalization with stent-retriever devices was successful (TICI ≥ 2) in 94.7%. Mean time to flow restoration was 36.7 minutes and to complete recanalization 83.7 minutes. Symptomatic intracranial hemorrhage occurred in 4 patients (21.1%). Eight patients had an NIHSS improvement of ≥4 points between admission and discharge. After 90 days, 2 (10.5%) of our patients presented with mRS 0-2; seven (36.8%) died. CONCLUSIONS: Despite successful and rapid recanalization with stent-retriever devices, good clinical outcome in patients with wake-up stroke is achieved in a minority of patients. Clinical outcome remains poor. Bleeding rates were higher compared with recanalization procedures within 6 hours after stroke onset.
BACKGROUND AND PURPOSE: Stent-retriever devices play an increasing role in the interventional treatment of acute strokepatients, because fast recanalization can be achieved. The purpose of this study was to evaluate the feasibility of stent-retriever recanalization in patients with wake-up stroke in the anterior circulation. MATERIALS AND METHODS: We retrospectively analyzed clinical and angiographic data of 19 consecutive patients with wake-up stroke who were treated with stent-retriever devices between 2009 and October 2011. Recanalization was assessed by using the Thrombolysis in Cerebral Infarction score. Clinical outcome was evaluated at discharge and after 90 days by using the modified Rankin Scale. RESULTS: Median NIHSS score at admission was 17 (IQR, 15-20). Before the procedure, the TICI score was 0 in 18 patients and 1 in 1 patient. Recanalization with stent-retriever devices was successful (TICI ≥ 2) in 94.7%. Mean time to flow restoration was 36.7 minutes and to complete recanalization 83.7 minutes. Symptomatic intracranial hemorrhage occurred in 4 patients (21.1%). Eight patients had an NIHSS improvement of ≥4 points between admission and discharge. After 90 days, 2 (10.5%) of our patients presented with mRS 0-2; seven (36.8%) died. CONCLUSIONS: Despite successful and rapid recanalization with stent-retriever devices, good clinical outcome in patients with wake-up stroke is achieved in a minority of patients. Clinical outcome remains poor. Bleeding rates were higher compared with recanalization procedures within 6 hours after stroke onset.
Authors: Carlos Castaño; Laura Dorado; Cristina Guerrero; Monica Millán; Meritxell Gomis; Natalia Perez de la Ossa; Mar Castellanos; M Rosa García; Sira Domenech; Antoni Dávalos Journal: Stroke Date: 2010-06-10 Impact factor: 7.914
Authors: Kennedy R Lees; Erich Bluhmki; Rüdiger von Kummer; Thomas G Brott; Danilo Toni; James C Grotta; Gregory W Albers; Markku Kaste; John R Marler; Scott A Hamilton; Barbara C Tilley; Stephen M Davis; Geoffrey A Donnan; Werner Hacke; Kathryn Allen; Jochen Mau; Dieter Meier; Gregory del Zoppo; D A De Silva; K S Butcher; M W Parsons; P A Barber; C Levi; C Bladin; G Byrnes Journal: Lancet Date: 2010-05-15 Impact factor: 79.321
Authors: Stefan Rohde; Stefan Haehnel; Christian Herweh; Mirko Pham; Sibylle Stampfl; Peter A Ringleb; Martin Bendszus Journal: Stroke Date: 2011-08-04 Impact factor: 7.914
Authors: Anthony J Furlan; Dirk Eyding; Gregory W Albers; Yasir Al-Rawi; Kennedy R Lees; Howard A Rowley; Christian Sachara; Mariola Soehngen; Steven Warach; Werner Hacke Journal: Stroke Date: 2006-03-30 Impact factor: 7.914
Authors: John N Fink; Sandeep Kumar; Clare Horkan; Italo Linfante; Magdy H Selim; Louis R Caplan; Gottfried Schlaug Journal: Stroke Date: 2002-04 Impact factor: 7.914
Authors: Yoshinari Nagakane; Soren Christensen; Toshiyasu Ogata; Leonid Churilov; Henry Ma; Mark W Parsons; Patricia M Desmond; Christopher R Levi; Kenneth S Butcher; Stephen M Davis; Geoffrey A Donnan Journal: Stroke Date: 2012-04-12 Impact factor: 7.914
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
Authors: W Hacke; M Kaste; C Fieschi; R von Kummer; A Davalos; D Meier; V Larrue; E Bluhmki; S Davis; G Donnan; D Schneider; E Diez-Tejedor; P Trouillas Journal: Lancet Date: 1998-10-17 Impact factor: 79.321
Authors: I Mourand; D Milhaud; C Arquizan; K Lobotesis; R Schaub; P Machi; X Ayrignac; O F Eker; A Bonafé; V Costalat Journal: AJNR Am J Neuroradiol Date: 2015-11-05 Impact factor: 3.825
Authors: Anke Wouters; Patrick Dupont; Soren Christensen; Bo Norrving; Rico Laage; Götz Thomalla; Stephanie Kemp; Maarten Lansberg; Vincent Thijs; Gregory W Albers; Robin Lemmens Journal: Eur Stroke J Date: 2018-02-01
Authors: Luís Henrique de Castro-Afonso; Guilherme Seizem Nakiri; Octávio Marques Pontes-Neto; Antônio Carlos dos Santos; Daniel Giansante Abud Journal: Cerebrovasc Dis Extra Date: 2016-03-31