Application of Solumbra technique thrombectomy in acute middle cerebral artery occlusion

Abstract

Objective To compare the efficacy and prognosis of Solumbra technique and simple stent mechanical thrombectomy for emergency revascularization in treating acute middle cerebral artery occlusion. Methods A total of 52 consecutive patients with acute middle cerebral artery occlusion admitted to the Cerebrovascular Disease Center, Changhai Hospital from September 2013 to December 2015 were enrolled retrospectively. According to whether using intermediate catheter, they were divided into study group and control group. There were 21 patients (male 13 cases) in the study group, using Solumbra technique with intermediate catheter. And another 31 patients (male 19 cases) were in the control group without using intermediate catheter. The vascular recanalization rate, complication rate, operation time and good prognosis at 90 d after operation were evaluated in the two groups. Results The patients′ age was elder and the onset-to-puncture time was shorter in the study group than those in the control group (t=2.806, t=-2.603, P 0.05). Comparing with the control group, the rate of first-pass thrombectomy achieving successful recanalization was higher and the average thrombectomy time was lower in the study group, which were 57.1% vs 29.0% (χ2=4.109, P 0.05). All the patients were followed up by telephone call or outpatient visit and the good outcome (modified Rankin Scale (mRS) score ≤2) at 90 days in the study group was better obviously, 71.4% vs 41.9% (χ2=4.382, P<0.05). Conclusions In the emergency revascularization of acute middle cerebral artery occlusion, the Solumbra technique is better at increasing the efficacy of thrombectomy and succession, reducing the incidence of secondary distal and ectopic embolization, and improving the good outcome (mRS score ≤2) at 90 days compared with simple stent mechanical thrombectomy. The results still need to be proved by large sample data in the future. Key words: Solumbra technique; Acute ischemic stroke; Middle cerebral artery occlusion; Thrombectomy