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Acta Neurochirurgica

, Volume 161, Issue 10, pp 2003–2012 | Cite as

Gradual expansion of stent retriever in mechanical thrombectomy for curved middle cerebral artery: structural findings of the stent for predictable recanalization results

  • Dae Han Choi
  • Chan Jong Yoo
  • Cheol Wan Park
  • Myeong Jin KimEmail author
Original Article - Vascular Neurosurgery - Ischemia
  • 90 Downloads
Part of the following topical collections:
  1. Vascular Neurosurgery - Ischemia

Abstract

Background

Trevo Provue stent retriever with visible struts under fluoroscopy may be useful in identifying the optimal position and expansion of the stent during the procedure. This study aimed to demonstrate and analyze changes in the segmental diameter of a radio-opaque stent retriever after deployment according to recanalization results, and its relationship with the angle of the occluded segment of the middle cerebral artery (MCA).

Methods

Forty-one patients who underwent mechanical thrombectomy using a Trevo stent retriever were divided into two groups according to Thrombolysis in Cerebral Infarction (TICI) score (TICI 0-2a and TICI 2b/3). The proximal (Pt), middle (Mt), and distal diameter (Dt) of the deployed stent, at three post-deployment waiting times (t = 0, 3, and 5 min), were measured, and ratios of Mt to Pt (Mt/Pt) and of Mt to Dt (Mt/Dt) were calculated.

Results

TICI 2b/3 was achieved in 31 patients (75.6%) and TICI 0-2a in 10 patients (24.4%). In the TICI 2b/3 group, both changes of Mt/Pt (P < 0.001) and Mt/Dt (P = 0.001) until 3 min were significant and all Mt/Pt (each P < 0.01), M3/D3 (P = 0.014), and M5/D5 (P = 0.012) were significantly larger than those in the TICI 0-2a group. The angle of the MCA was significantly correlated with Mt/Pt and Mt/Dt (P < 0.001).

Conclusion

The diameter of the stent retriever after deployment was associated with the recanalization results in mechanical thrombectomy following MCA occlusion.

Keywords

Mechanical thrombolysis Middle cerebral artery thrombosis Stent Thrombectomy 

Notes

Compliance with ethical standards

All procedures performed in this study were in accordance with the ethical standards of the institute and with the 1964 Helsinki Declaration and its later amendments. Formal consent was not required for the collection of this data.

Informed consent

For this type of study, formal consent is not required.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Neurosurgery, Gil Medical CenterGachon University College of MedicineIncheonRepublic of Korea

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