L Will1, V Maus1, C Maurer2, A Weber1, W Weber1, S Fischer3. 1. Institut für Diagnostische und Interventionelle Radiologie, Neuroradiologie und Nuklearmedizin, Knappschaftskrankenhaus Bochum-Universitätsklinikum Bochum, In der Schornau 23-25, 44829, Bochum, Germany. 2. Klinik für Diagnostische, Radiologie und Neuroradiologie, Universitätsklinikum Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany. 3. Institut für Diagnostische und Interventionelle Radiologie, Neuroradiologie und Nuklearmedizin, Knappschaftskrankenhaus Bochum-Universitätsklinikum Bochum, In der Schornau 23-25, 44829, Bochum, Germany. sebif101@googlemail.com.
Abstract
OBJECTIVE: The aim of this study was to evaluate the safety and efficacy of a manually expandable stent retriever (Tigertriever, Rapid Medical, Yoqneam, Israel) in the treatment of acute ischemic stroke caused by intracranial large vessel occlusions (LVO). METHODS: We performed a single center retrospective analysis of all patients treated by mechanical thrombectomy due to LVO using the Tigertriever. The angiographic and clinical success was evaluated by the modified thrombolysis in cerebral infarction score (mTICI) and the modified Rankin score (mRS). RESULTS: A total of 68 acute intracranial arterial occlusions in 61 patients (42 female, median age 77 years, range 43-92 years) were treated by mechanical thrombectomy using the Tigertriever. The overall successful reperfusion rate (mTICI 2b-3) was 85.3% (58/68 occlusions) with a first pass effect (mTICI 3) of 23.5% (16/68 occlusions). In 57 of the 68 occlusions the Tigertriever was used on an intention to treat approach with a success rate of 86.0% and in the 11 remaining occlusions where the Tigertriever was used as a bail-out device the success rate was 81.9%. In seven patients a mild subarachnoid hemorrhage occurred (11.5%) and one symptomatic intracerebral hemorrhage was observed (1.6%). At discharge 39.3% of the patients (24/61) had a favorable outcome (mRS 0-2). CONCLUSION: The Tigertriever offers a safe and effective treatment option in ischemic stroke due to LVOs with reperfusion rates and a safety profile similar to alternative devices. The Tigertriever is a promising bail-out tool in complex cases. Its role as a first line device has to be evaluated in further prospective studies.
OBJECTIVE: The aim of this study was to evaluate the safety and efficacy of a manually expandable stent retriever (Tigertriever, Rapid Medical, Yoqneam, Israel) in the treatment of acute ischemic stroke caused by intracranial large vessel occlusions (LVO). METHODS: We performed a single center retrospective analysis of all patients treated by mechanical thrombectomy due to LVO using the Tigertriever. The angiographic and clinical success was evaluated by the modified thrombolysis in cerebral infarction score (mTICI) and the modified Rankin score (mRS). RESULTS: A total of 68 acute intracranial arterial occlusions in 61 patients (42 female, median age 77 years, range 43-92 years) were treated by mechanical thrombectomy using the Tigertriever. The overall successful reperfusion rate (mTICI 2b-3) was 85.3% (58/68 occlusions) with a first pass effect (mTICI 3) of 23.5% (16/68 occlusions). In 57 of the 68 occlusions the Tigertriever was used on an intention to treat approach with a success rate of 86.0% and in the 11 remaining occlusions where the Tigertriever was used as a bail-out device the success rate was 81.9%. In seven patients a mild subarachnoid hemorrhage occurred (11.5%) and one symptomatic intracerebral hemorrhage was observed (1.6%). At discharge 39.3% of the patients (24/61) had a favorable outcome (mRS 0-2). CONCLUSION: The Tigertriever offers a safe and effective treatment option in ischemic stroke due to LVOs with reperfusion rates and a safety profile similar to alternative devices. The Tigertriever is a promising bail-out tool in complex cases. Its role as a first line device has to be evaluated in further prospective studies.
Authors: Rishi Gupta; Jeffrey L Saver; Elad Levy; Osama O Zaidat; Dileep Yavagal; David S Liebeskind; Ahmad Khaldi; Bradley Gross; Michael Lang; Sandra Narayanan; Brian Jankowitz; Kenneth Snyder; Adnan Siddiqui; Jason Davies; Eugene Lin; Ameer Hassan; Ricardo Hanel; Amin Aghaebrahim; Ritesh Kaushal; Ali Malek; Nils Mueller-Kronast; Robert Starke; Hormozd Bozorgchami; Gary Nesbit; Masahiro Horikawa; Ryan Priest; Jesse Liu; Ronald F Budzik; Peter Pema; Nirav Vora; M Asif Taqi; Edgar Samaniego; Qingliang Tony Wang; Erez Nossek; Guilherme Dabus; Italo Linfante; Ajit Puri; Eitan Abergel; Sidney Starkman; Satoshi Tateshima; Ashutosh P Jadhav Journal: Stroke Date: 2021-03-19 Impact factor: 7.914