Mechanical Thrombectomy Using the new Solitaire™ Platinum Stent-retriever : Reperfusion Results, Complication Rates and Early Neurological Outcome.

BACKGROUND AND PURPOSE

The application of radiopaque markers to the Solitaire™ stent-retriever for better visibility during mechanical thrombectomy (MT) has the potential to alter the well-known characteristics of the device; however, it is uncertain whether this adjustment influences efficacy or safety of the enhanced stent-retriever.

METHODS

Retrospective analysis of stroke databases of three comprehensive stroke centers. Our investigation was focused on technical and angiographic parameters, including procedure times, reperfusion results (thrombolysis in cerebral infarction, TICI), periprocedural complications and favorable early neurological recovery at discharge (modified Rankin scale ≤2 or National Institutes of Health Stroke Scale, NIHSS = 0 or ∆NIHSS ≥ 10), from consecutive patients with acute anterior circulation ischemic stroke treated with a Solitaire™ Platinum stent-retriever between October 2016 and March 2017.

RESULTS

A total of 75 patients (male: n = 27, 36%, age in years: mean (SD): 75 (±12), median baseline NIHSS: 17 (interquartile range IQR: 11-21), n = 41, 54.7% received additional i. v. thrombolytics) were treated with a median number of 2 device passes (range: 1-5). The median time from groin puncture to final TICI was 56 min (IQR: 41-79). In 69 patients (92%) TICI 2b-3 was achieved. Early neurological recovery was seen in 47 (62.7%) patients. The following periprocedural complications occurred: vasospasms (n = 7, 9.3%), emboli into a new territory (n = 4, 5.3%), symptomatic intracranial hemorrhage (n = 3, 4%), difficulties during device delivery/deployment (n = 1, 1.3%).

CONCLUSION

The usage of the Solitaire™ Platinum stent-retriever for MT in acute ischemic stroke patients was highly effective and was not accompanied by an increased periprocedural complication rate.