The Limitations of Thrombectomy with Solitaire™ AB as First-line Treatment in Acute Ischemic Stroke: A Single Center Experience

Abstract

ObjectiveA self-expanding retrievable intracranial stent, such as Solitaire AB, is useful for mechanical thrombectomy, producing novel results in the treatment of acute ischemic stroke. On the other hand, difficult situations can arise after a thrombectomy when using as in first-line treatment.MethodsThis was a retrospective, single-center study of 23 patients with an acute ischemic stroke attributable to a large artery occlusion within the first eight hours from symptom onset. The occlusion sites were the T segment in five patients, proximal middle cerebral artery in six patients, distal middle cerebral artery in three patients, vertebral and/or basilar artery in five patients, proximal internal cerebral artery in one patient and tandem in three patients. All patients underwent a mechanical thrombectomy using the Solitaire™ stent system as the first-line treatment but required additional procedures due to the unsatisfactory results of a thrombectomy.ResultsOnly six patients achieved complete recanalization by a thrombectomy using the Solitaire. Permanent stent deployment after the thrombectomy was performed in ten patients. Stent and balloon angioplasty was performed after a stent-based thrombectomy in six patients. Balloon angioplasty after thrombectomy was performed in one patient.ConclusionMechanical thrombectomy with the Solitaire™ stent as a first-line treatment can produce unfortunate results that will require additional procedures.