Abstract

Little is known about the consequences of arterial wall damage that may be due to mechanical endovascular thrombectomy. Our aim was to perform 1-year MR angiographic and clinical follow-up of patients treated with mechanical endovascular thrombectomy using the Solitaire device. Patients with stroke treated between August 2010 and July 2012 were prospectively evaluated with a minimum follow-up of 1 year after mechanical endovascular thrombectomy. Angiographic follow-up was performed on a 3T MR imaging scanner and included intracranial artery TOF MRA and supra-aortic artery gadolinium-enhanced MRA. Images were assessed to detect arterial abnormalities (stenosis, occlusion, dilation) and were compared with the final post-mechanical endovascular thrombectomy run to differentiate delayed and pre-existing abnormalities. Clinical evaluation was performed with the mRS and the 36-Item Short-Form Health Survey questionnaire quality-of-life scale. Thirty-nine patients were angiographically assessed at the mean term of 19 ± 4 months. MRA showed intracranial artery abnormalities in 10 patients, including 5 delayed intracranial artery abnormalities in 4 patients (4 stenoses and 1 dilation), 4 cases of pre-existing intracranial artery stenosis, and 2 occlusions. Pre-existing etiologic cervical artery stenosis or occlusion was observed in 2 patients. All these patients remained asymptomatic during the follow-up period. A significant clinical improvement was observed at 1-year follow-up in comparison with 3-month follow-up (P < .0001), with a good outcome achieved in 62.5% of patients and an acceptable quality of life restored. One-year follow-up identifies delayed asymptomatic arterial abnormalities in patients treated with the Solitaire device.

Highlights

  • BACKGROUND AND PURPOSELittle is known about the consequences of arterial wall damage that may be due to mechanical endovascular thrombectomy

  • Evaluation of mechanical endovascular thrombectomy (MET) safety and efficacy has mainly relied on shortterm 3-month clinical follow-up, but no data have been available about angiographic arterial changes related to MET procedures or Received February 8, 2014; accepted after revision April 21

  • For 1 of these patients, de novo Ͼ50% stenosis of the inferior M2 branch coexisted with dilation of the superior M2 branch, compared with the final post-MET run, which showed no stenosis but a suggestive dissection flap on the inferior M2 branch (Fig 1)

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Summary

Objectives

Our aim was to perform 1-year MR angiographic and clinical follow-up of patients treated with mechanical endovascular thrombectomy using the Solitaire device. The purpose of this study was to perform 1-year 3T MR angiographic FU of patients treated with a Solitaire device to identify potential wall damage

Methods
Results
Discussion
Conclusion

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