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Intracranial bailout stenting with the Acclino (Flex) Stent/NeuroSpeed Balloon Catheter after failed thrombectomy in acute ischemic stroke: a multicenter experience.

Abstract

BACKGROUND AND PURPOSE

To report on the feasibility, safety, and outcome of acute intracranial stenting (ICS) with the Acclino (Flex) Stent and NeuroSpeed Balloon Catheter in cases of failed mechanical thrombectomy (MT) for acute ischemic stroke (AIS).

METHODS

We retrospectively reviewed the data of patients treated with acute bailout stenting after failed MT in three large neurointerventional centers using exclusively the Acclino (Flex) Stent and the NeuroSpeed Balloon Catheter. Functional outcome was assessed by the rate of major early neurological recovery (mENR) at 24 hours and at 90 days with the modified Rankin Scale (mRS). Safety evaluation included symptomatic intracranial hemorrhage (sICH), mortality, and intervention-related serious adverse events (SAEs).

RESULTS

50 patients with a median age of 71 years met the inclusion criteria and 52% (26/50) of the occluded vessels were located within the anterior circulation. mENR was observed in 38.8% and 90-day favorable outcome (mRS ≤2) was 40.6% (13/32). Higher NIH Stroke Scale scores on admission were significantly associated with poor functional outcome (mRS ≥3) at 90 days (adjusted OR 1.28; 95% CI 1.07 to 1.53; p=0.007). sICH occurred in two cases of the study population. There were no intervention-related SAEs.

CONCLUSION

Intracranial bailout stenting with the Acclino (Flex) Stent and the NeuroSpeed Balloon Catheter after failed MT is a feasible and effective recanalization method for atherosclerotic stenosis-based stroke that is associated especially with low rates of sICH.

Authors+Show Affiliations

Department of Intracranial Endovascular Therapy, Alfried Krupp Klinikum Essen, Essen, Germany. Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.Department of Neurology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.Department of Neurology, Klinikum Osnabrück GmbH, Osnabruck, Germany.Department of Radiology, Klinikum Osnabrück GmbH, Osnabruck, Germany.Department of Radiology, Klinikum Osnabrück GmbH, Osnabruck, Germany.Department of Intracranial Endovascular Therapy, Alfried Krupp Klinikum Essen, Essen, Germany.Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31239330

Citation

Stracke, Christian Paul, et al. "Intracranial Bailout Stenting With the Acclino (Flex) Stent/NeuroSpeed Balloon Catheter After Failed Thrombectomy in Acute Ischemic Stroke: a Multicenter Experience." Journal of Neurointerventional Surgery, 2019.
Stracke CP, Meyer L, Fiehler J, et al. Intracranial bailout stenting with the Acclino (Flex) Stent/NeuroSpeed Balloon Catheter after failed thrombectomy in acute ischemic stroke: a multicenter experience. J Neurointerv Surg. 2019.
Stracke, C. P., Meyer, L., Fiehler, J., Leischner, H., Bester, M., Buhk, J. H., ... Hanning, U. (2019). Intracranial bailout stenting with the Acclino (Flex) Stent/NeuroSpeed Balloon Catheter after failed thrombectomy in acute ischemic stroke: a multicenter experience. Journal of Neurointerventional Surgery, doi:10.1136/neurintsurg-2019-014957.
Stracke CP, et al. Intracranial Bailout Stenting With the Acclino (Flex) Stent/NeuroSpeed Balloon Catheter After Failed Thrombectomy in Acute Ischemic Stroke: a Multicenter Experience. J Neurointerv Surg. 2019 Jun 25; PubMed PMID: 31239330.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intracranial bailout stenting with the Acclino (Flex) Stent/NeuroSpeed Balloon Catheter after failed thrombectomy in acute ischemic stroke: a multicenter experience. AU - Stracke,Christian Paul, AU - Meyer,Lukas, AU - Fiehler,Jens, AU - Leischner,Hannes, AU - Bester,Maxim, AU - Buhk,Jan Hendrik, AU - Thomalla,Goetz, AU - Krause,Lars Udo, AU - Lowens,Stephan, AU - Rothaupt,Jan, AU - Chapot,René, AU - Hanning,Uta, Y1 - 2019/06/25/ PY - 2019/03/25/received PY - 2019/05/23/revised PY - 2019/05/27/accepted PY - 2019/6/27/entrez KW - intervention KW - stent KW - stroke KW - thrombectomy KW - thrombolysis JF - Journal of neurointerventional surgery JO - J Neurointerv Surg N2 - BACKGROUND AND PURPOSE: To report on the feasibility, safety, and outcome of acute intracranial stenting (ICS) with the Acclino (Flex) Stent and NeuroSpeed Balloon Catheter in cases of failed mechanical thrombectomy (MT) for acute ischemic stroke (AIS). METHODS: We retrospectively reviewed the data of patients treated with acute bailout stenting after failed MT in three large neurointerventional centers using exclusively the Acclino (Flex) Stent and the NeuroSpeed Balloon Catheter. Functional outcome was assessed by the rate of major early neurological recovery (mENR) at 24 hours and at 90 days with the modified Rankin Scale (mRS). Safety evaluation included symptomatic intracranial hemorrhage (sICH), mortality, and intervention-related serious adverse events (SAEs). RESULTS: 50 patients with a median age of 71 years met the inclusion criteria and 52% (26/50) of the occluded vessels were located within the anterior circulation. mENR was observed in 38.8% and 90-day favorable outcome (mRS ≤2) was 40.6% (13/32). Higher NIH Stroke Scale scores on admission were significantly associated with poor functional outcome (mRS ≥3) at 90 days (adjusted OR 1.28; 95% CI 1.07 to 1.53; p=0.007). sICH occurred in two cases of the study population. There were no intervention-related SAEs. CONCLUSION: Intracranial bailout stenting with the Acclino (Flex) Stent and the NeuroSpeed Balloon Catheter after failed MT is a feasible and effective recanalization method for atherosclerotic stenosis-based stroke that is associated especially with low rates of sICH. SN - 1759-8486 UR - https://www.unboundmedicine.com/medline/citation/31239330/Intracranial_bailout_stenting_with_the_Acclino_(Flex)_Stent/NeuroSpeed_Balloon_Catheter_after_failed_thrombectomy_in_acute_ischemic_stroke:_a_multicenter_experience L2 - http://jnis.bmj.com/cgi/pmidlookup?view=long&pmid=31239330 DB - PRIME DP - Unbound Medicine ER -