A Mpotsaris1, M Bussmeyer, W Weber. 1. Klinik für Radiologie, Neuroradiologie und interventionelle Therapie, Klinikum Vest, Knappschaftskrankenhaus Recklinghausen, Dorstener Str. 151, 45657, Recklinghausen, Germany, anastasios.mpotsaris@klinikum-vest.de.
Abstract
BACKGROUND AND PURPOSE: Intravenous recombinant human tissue plasminogen activator (IV rtPA) therapy has limited revascularization rates in large artery occlusions. We describe the safety and effectiveness of the self-expanding, fully retrievable Separator 3D device as a component of the Penumbra System in revascularization of large artery occlusion in acute ischemic stroke. The 3D secures thrombus with lesional aspiration and functions by retrieving or debulking the clot. MATERIALS AND METHODS: Prospective, single-center pilot study of 20 patients with an acute ischemic stroke secondary to a large artery occlusion within 9 h from symptom onset. The occlusion sites were middle cerebral artery in nine patients, internal carotid artery terminus in eight patients, and basilar artery in three patients. Thrombectomy was performed in 18 patients who had previously received IV rtPA, and of these, two patients had prior failed treatment with the Solitaire stent. One patient had prior failed treatment with the Revive stent. RESULTS: Successful revascularization defined by Thrombolysis in Cerebral Infarction grade 2b-3 was achieved in 17 of 20 (85%) treated vessels. The median time from symptom onset to recanalization was 4.4 h (interquartile range 3.8-5.6 h). No procedural complications occurred, and no symptomatic intracranial hemorrhage was observed. Three (15%) patients died. At 90 days, 50% of patients showed good functional outcome (modified Rankin Scale score ≤ 2). CONCLUSION: Early results suggest that the Separator 3D, which combines a retriever with lesional aspiration, enables safe and effective revascularization.
BACKGROUND AND PURPOSE: Intravenous recombinant humantissue plasminogen activator (IV rtPA) therapy has limited revascularization rates in large artery occlusions. We describe the safety and effectiveness of the self-expanding, fully retrievable Separator 3D device as a component of the Penumbra System in revascularization of large artery occlusion in acute ischemic stroke. The 3D secures thrombus with lesional aspiration and functions by retrieving or debulking the clot. MATERIALS AND METHODS: Prospective, single-center pilot study of 20 patients with an acute ischemic stroke secondary to a large artery occlusion within 9 h from symptom onset. The occlusion sites were middle cerebral artery in nine patients, internal carotid artery terminus in eight patients, and basilar artery in three patients. Thrombectomy was performed in 18 patients who had previously received IV rtPA, and of these, two patients had prior failed treatment with the Solitaire stent. One patient had prior failed treatment with the Revive stent. RESULTS: Successful revascularization defined by Thrombolysis in Cerebral Infarction grade 2b-3 was achieved in 17 of 20 (85%) treated vessels. The median time from symptom onset to recanalization was 4.4 h (interquartile range 3.8-5.6 h). No procedural complications occurred, and no symptomatic intracranial hemorrhage was observed. Three (15%) patients died. At 90 days, 50% of patients showed good functional outcome (modified Rankin Scale score ≤ 2). CONCLUSION: Early results suggest that the Separator 3D, which combines a retriever with lesional aspiration, enables safe and effective revascularization.
Authors: J Berge; A Biondi; P Machi; H Brunel; L Pierot; J Gabrillargues; K Kadziolka; X Barreau; V Dousset; A Bonafé Journal: AJNR Am J Neuroradiol Date: 2012-02-02 Impact factor: 3.825
Authors: Raul G Nogueira; Helmi L Lutsep; Rishi Gupta; Tudor G Jovin; Gregory W Albers; Gary A Walker; David S Liebeskind; Wade S Smith Journal: Lancet Date: 2012-08-26 Impact factor: 79.321
Authors: Jeffrey L Saver; Reza Jahan; Elad I Levy; Tudor G Jovin; Blaise Baxter; Raul G Nogueira; Wayne Clark; Ronald Budzik; Osama O Zaidat Journal: Lancet Date: 2012-08-26 Impact factor: 79.321
Authors: Robert Tarr; Dan Hsu; Zsolt Kulcsar; Christophe Bonvin; Daniel Rufenacht; Karsten Alfke; Robert Stingele; Olav Jansen; Donald Frei; Richard Bellon; Michael Madison; Tobias Struffert; Arnd Dorfler; Iris Q Grunwald; Wolfgang Reith; Anton Haass Journal: J Neurointerv Surg Date: 2010-12 Impact factor: 5.836
Authors: C Roth; P Papanagiotou; S Behnke; S Walter; A Haass; C Becker; K Fassbender; M Politi; H Körner; M-S Romann; W Reith Journal: Stroke Date: 2010-10-14 Impact factor: 7.914
Authors: Arthur M Pancioli; Joseph Broderick; Thomas Brott; Thomas Tomsick; Jane Khoury; Judy Bean; Gregory del Zoppo; Dawn Kleindorfer; Daniel Woo; Pooja Khatri; John Castaldo; James Frey; James Gebel; Scott Kasner; Chelsea Kidwell; Thomas Kwiatkowski; Richard Libman; Richard Mackenzie; Phillip Scott; Sidney Starkman; R Jason Thurman Journal: Stroke Date: 2008-09-04 Impact factor: 7.914
Authors: Paolo Machi; Vincent Costalat; Kyriakos Lobotesis; Igor Lima Maldonado; Jean Francois Vendrell; Carlos Riquelme; Alain Bonafé Journal: J Neurointerv Surg Date: 2011-04-07 Impact factor: 5.836
Authors: Colin J Przybylowski; Dale Ding; Robert M Starke; Christopher R Durst; R Webster Crowley; Kenneth C Liu Journal: World J Clin Cases Date: 2014-11-16 Impact factor: 1.337
Authors: Raul G Nogueira; Donald Frei; Jawad F Kirmani; Osama Zaidat; Demetrius Lopes; Aquilla S Turk; Donald Heck; Brian Mason; Diogo C Haussen; Elad I Levy; Siddhart Mehta; Marc Lazzaro; Michael Chen; Arnd Dörfler; Albert J Yoo; Colin P Derdeyn; Lee Schwamm; David Langer; Adnan Siddiqui Journal: JAMA Neurol Date: 2018-03-01 Impact factor: 18.302
Authors: Andreas Simgen; Michael Kettner; Frida Juliane Webelsiep; Toshiki Tomori; Ruben Mühl-Benninghaus; Umut Yilmaz; Pervinder Bhogal; Matthias W Laschke; Michael D Menger; Wolfgang Reith; Philipp Dietrich Journal: Clin Neuroradiol Date: 2020-05-18 Impact factor: 3.649