Mechanical embolectomy by means of the Merci retriever in patients with acute occlusion of brain arteries

Czech version

Authors: F. Charvát ¹; J. Lacman ¹; J. Mašková ¹; J. Elis ²; V. Beneš ³
Authors‘ workplace: RDG oddělení ÚVN Praha 6 – Střešovice ¹; Neurologické oddělení ÚVN Praha – Střešovice ²; Neurochirurgická klinika, Univerzita Karlova v Praze, 1. lékařská fakulta, IPVZ a ÚVN Praha – Střešovice ³
Published in: Cesk Slov Neurol N 2008; 71/104(1): 69-74
Category: Short Communication

Overview

Objectives:
The authors present their first experience with mechanical embolectomy as a treatment modality for patients with acute cerebral ischemia. Methods: From July to December 2006 mechanical embolectomy was performed in a group of 7 patients (5 men and 2 women) who presented with symptoms of acute brain artery occlusion (NIHSS score 5-25). After a CT scan including CT perfusion, embolectomy by means of the Merci Retriever was urgently performed. The basilar artery was occluded in three patients, M1 in two and M2 in one patient. ICA and parts of the M1 and A1 (T-occlusion) were affected in one patient.

Results:
Successful reperfusion was achieved in six patients (85,8 %) and no serious periprocedural complications were observed during the treatment. Intraarterial administration of alteplase (3 mg) was necessary to dissolve distal emboli in one patient, PTA of the basilar artery due to stenosis was performed in two cases and in one patient stenosis of the internal carotis artery was resolved by stent implantation. The resulting Rankin Score 30 days following treatment was 1 or 2 in 5 cases (71,4 %), 5 in one and one patient died within 30 days after treatment.

Conclusion:
Mechanical embolectomy proved to be a suitable treatment modality for selected patients with acute cerebral ischemia as it is very effectively able to revascularize occluded artery in an eight-hour therapeutic window.

Key words:
stroke, mechanical embolectomy, therapeutic window

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