Litao Miguel S, Nossek Erez, DeSousa Keith, Favate Albert, Raz Eytan, Shapiro Maksim, Becske Tibor, Nelson Peter Kim
New York University Langone Medical Center, New York, New York, USA.
Interv Neurol. 2018 Feb;7(1-2):6-11. doi: 10.1159/000480245. Epub 2017 Sep 27.
Scarce reports exist of permanent deployment of Solitaire FR™ devices for arterial steno-occlusive disease as it is primarily indicated for temporary deployment for thrombectomy in large-vessel, anterior-circulation ischemic strokes. Even more scarce are reports describing permanent deployment of the Solitaire device for posterior circulation strokes.
We present 2 cases where the Solitaire device was electrolytically detached to re-establish flow in an occluded or stenotic basilar artery in acutely symptomatic patients. In both cases, a 4 × 15 mm Solitaire device was positioned across the stenotic or occluded portion of the basilar artery and electrolytically detached to maintain vessel patency. Both cases had good clinical outcomes with a National Institutes of Health Stroke Scale (NIHSS) score of 1 (from 24) on 90-day follow-up and an NIHSS score of 2 (from 7) on 30-day follow-up.
Permanent deployment of the Solitaire device may potentially be a safe and effective means of maintaining vessel patency in an occluded or stenotic basilar artery.
关于使用Solitaire FR™装置永久性治疗动脉狭窄闭塞性疾病的报道较少,因为该装置主要用于在大血管、前循环缺血性卒中的血栓切除术的临时使用。描述Solitaire装置用于后循环卒中永久性治疗的报道更为罕见。
我们报告2例急性症状性患者,通过电解脱开Solitaire装置以重建闭塞或狭窄的基底动脉血流。在这2例患者中,均将4×15mm的Solitaire装置置于基底动脉狭窄或闭塞部位,并通过电解脱开以维持血管通畅。2例患者临床结局良好,90天随访时美国国立卫生研究院卒中量表(NIHSS)评分从(24分)降至1分,30天随访时NIHSS评分从(7分)降至2分。
永久性植入Solitaire装置可能是维持闭塞或狭窄基底动脉血管通畅的一种安全有效的方法。