Solitaire AB Research Articles

Preliminary outcomes of endovascular treatment of moyamoya disease

PurposeThis study aimed to investigate the effectiveness and safety of endovascular revascularisation of intracranial artery occlusion and stenosis in moyamoya disease using stent angioplasty. Materials and methodsWe recruited 12 patients (8 women and 4 men) with occlusion and stenosis of intracranial arteries in the context of moyamoya disease who underwent endovascular stent angioplasty. Clinical data, baseline conditions, lesion location, treatment outcomes, periprocedural complications, and follow-up outcomes were analysed. ResultsThe occlusion was located at the M1 segment of the middle cerebral artery in 8 patients, at both the M1 and A2 segments in one patient, and at the C7 segment of the internal carotid artery in 3. Thirteen stents were deployed at the occlusion site, including the low-profile visualized intraluminal support (LVIS) device in 8 patients, an LVIS device and a Solitaire AB stent in one, and a Leo stent in 3, with a success rate of 100% and no intraprocedural complications. Plain CT imaging after stenting revealed leakage of contrast agent, which disappeared on the second day, resulting in no clinical symptoms or neurological sequelae. Follow-up angiography studies were performed in all patients for 6–12 months (mean, 8.8). Slight asymptomatic in-stent stenosis was observed in 2 patients (16.7%), and no neurological deficits were observed in the other patients. All preoperative ischaemic symptoms completely disappeared at follow-up. ConclusionStent angioplasty is a safe and effective treatment for occlusion and stenosis of intracranial arteries in moyamoya disease.

Observation of Efficacy of rt-PA Thrombolysis Combined with Solitaire AB Stent Mechanical Thrombectomy in Patients with Acute Ischemic Stroke: A Retrospective Analysis

Objective: To observe and analyze the efficacy of recombinant tissue-plasminogen activator (rt-PA) thrombolysis combined with Solitaire AB stent mechanical thrombectomy in patients with acute ischemic stroke. Methods: Clinical efficacy, neurological function, oxidative stress response, adverse reactions, and quality of life were compared between the two groups. Results: Lower NIHSS scores were observed among patients who received treatment within 2 hours after stroke onset when compared with those in a timeframe of 2-6 hours, suggesting better neurological function recovery of the patients with early intervention and thus emphasizing the importance of early treatment for patients with stroke onset. Clinical efficacy in the combination group was significantly higher than in the control group (P < 0.05). After treatment, Paraoxonase-1 (PON-1) levels were higher, while lipoprotein-associated phospholipase A2 (Lp-PLA2) and Serum Amyloid A (SAA) levels were lower in the combination group compared to the control group (P < 0.05). The incidence of adverse reactions was significantly lower in the combination group (P < 0.05). At discharge, we observed significantly more patients with good recovery in the combination group when compared to the control group (P < 0.05), suggesting better quality of life of the patients, while this statistical significance was no longer observable at 90 days after discharge (P > 0.05). Conclusion: For acute ischemic stroke patients, rt-PA thrombolysis combined with Solitaire AB stent mechanical thrombectomy treatment is effective. It promotes neurological function recovery, improves vascular stenosis, reduces inflammation and adverse reactions, and enhances quality of life, showing promising clinical applications.

Effects of Solitaire AB stent thrombectomy with tirofiban and butylphthalide on neurological function and inflammatory factors in acute cerebral infarction patients

Background Acute cerebral infarction profoundly affects patients’ neurological function and quality of life. This study explores the impact of Solitaire AB stent thrombectomy, combined with tirofiban and butylphthalide, on neurological function and inflammatory factors in patients with acute cerebral infarction. Methods Seventy-three eligible patients treated between 2021 and 2023 were divided into a control group (Solitaire AB stent thrombectomy) and a treatment group (Solitaire AB stent thrombectomy with tirofiban and butylphthalide). Postoperative neurological function scores and inflammatory factor levels were analyzed. Results The treatment group demonstrated a higher clinical effective rate, lower National Institutes of Health Stroke Scale scores at one day and seven days and higher Mini-Mental State Examination and Montreal Cognitive Assessment scores post-treatment. Inflammatory factor levels (Neuron Specific Enolase (NSE), S100-β, TNF-α and IL-6) were lower in the treatment group. No significant differences in adverse outcomes were observed. Conclusion Solitaire AB stent thrombectomy with tirofiban and butylphthalide shows superior efficacy, improving neurological function and inflammatory factors without increasing adverse outcomes. This offers valuable insights for clinical treatment of acute cerebral infarction.

Image-based visualization of stents in mechanical thrombectomy for acute ischemic stroke: Preliminary findings from a series of cases.

Mechanical thrombectomy is the most effective treatment for great cerebral artery embolization within a set time window. Typically, an arteriogram does not show the localization of the stent after release and whether a thrombus is captured or not. Thus, improving the visualization of a stent in interventional therapy will be helpful for clinicians. To analyze stent imaging findings to enhance clinicians' understanding of a special circumstance, wherein a Solitaire AB retrievable stent was visible during the imaging of a thrombus capture that improved the success rate of stent-based mechanical thrombectomy. This was a retrospective study with four acute ischemic stroke (AIS) patients who underwent stent-based mechanical thrombectomy. Patient 1 was a 64-year-old man admitted after 5 h of confusion; angiography revealed basilar artery occlusion. We inserted a stent into the left posterior cerebral artery-P2 segment and visualized the expanded stent that successfully captured a thrombus. Patient 2 was a 74-year-old man admitted with confusion, which lasted approximately 3 h. Angiography revealed a left middle cerebral artery (MCA)-M1 segment occlusion. A stent was deployed in the distal M2 segment, and we could visualize the stent by capturing the thrombus. Patient 3 was a 74-year-old woman admitted after experiencing left hemiplegia for 3 h. We deployed a stent at the distal right MCA-M2 segment, and the developing stent captured a large thrombus. Patient 4 was an 82-year-old man who presented with confusion for 3 h. A developing stent was placed in the distal left MCA-M1 segment, which captured a large thrombus and several fragmented thrombi. To the best of our knowledge, this is the first report of stent imaging in patients with AIS. We demonstrated the usefulness and substantial potential of stent imaging in stent-based mechanical thrombectomy for AIS.

Fracture and dislodgment of a guidewire retrieved by a Solitaire AB neurovascular remodeling device

Background: Guidewire fracture and dislodgment are very rare but can cause serious complications. Method: A case was reported where part of the guidewire was blocked to the posterior tibial. We attempted to remove it using a Solitaire AB Neurovascular Remodeling Device. Result: A Solitaire AB Neurovascular Remodeling Device was successfully used to remove the fracture and dislodgment of a guidewire. There were no complications during the removal of the guidewire. Conclusion: A Solitaire AB can be used to remove a fractured guidewire, which is a simple and effective method to reduce complications. The Solitaire stent gradually crimped and tightened to form a dense inverted conical meshwork, similar to the “trans embolic protection device.” We can use minimally invasive methods to remove a broken and displaced guidewire within the vascular lumen.

Comparative study on treatment of acute cerebral infarction between mechanical thrombectomy by micro catheter and thrombectomy by Solitaire AB stent.

Background:Acute cerebral artery occlusion is a common disease with high morbidity and mortality. At present, the commonly used mechanical thrombectomy schemes are mechanical thrombectomy and stent thrombectomy. However, the clinical differences between the two methods is not fully understood. The present study aimed to evaluate the clinical effectiveness of Solitaire AB stent thrombectomy for acute cerebral infarction (ACI).Methods:A retrospective study was carried out in 96 ACI patients admitted to our department from January 2017 to January 2020. According to the treatment they received, they were divided into group A (conventional microcatheter mechanical thrombectomy, n = 48) and group B (Solitaire AB stent thrombectomy, n = 48). All patients were followed up for 3 months. Their pre- and post-operative nerve function indices were compared between the 2 groups. The therapeutic effects were evaluated by thrombolysis in cerebral infarction scale system, Glasgow coma scale (GCS), National Institutes of Health Stroke Scale (NIHSS), and modified Rankin scale statistics.Results:Two groups of patients with NIHSS scores postoperative 3 and 30 days decreased significantly compared with preoperation. NIHSS score of group A 3 and 30 days postoperation was significantly higher than group B (P < .05). Two groups of patients with GCS scores postoperative 3 and 30 days increased significantly compared with preoperation. GCS score of group A 3 and 30 days postoperation was significantly lower than group B (P < .05). Group B with vascular recanalization ratio postoperative 30 days was higher than group A, however with no significant differences (P > .05). Moreover, group B with outcomes (modified Rankin scale score ≤2 points) postoperative 3 months was better than group A, however with no significant differences (P > .05).Conclusion:Solitaire AB stent embolectomy shows similar efficacy as mechanical thrombectomy in the treatment of ACI patients.

Preliminary outcomes of endovascular treatment of moyamoya disease

PurposeThis study aimed to investigate the effectiveness and safety of endovascular revascularisation of intracranial artery occlusion and stenosis in moyamoya disease using stent angioplasty. Materials and methodsWe recruited 12 patients (8 women and 4 men) with occlusion and stenosis of intracranial arteries in the context of moyamoya disease who underwent endovascular stent angioplasty. Clinical data, baseline conditions, lesion location, treatment outcomes, periprocedural complications, and follow-up outcomes were analysed. ResultsThe occlusion was located at the M1 segment of the middle cerebral artery in 8 patients, at both the M1 and A2 segments in one patient, and at the C7 segment of the internal carotid artery in 3. Thirteen stents were deployed at the occlusion site, including the low-profile visualized intraluminal support (LVIS) device in 8 patients, an LVIS device and a Solitaire AB stent in one, and a Leo stent in 3, with a success rate of 100% and no intraprocedural complications. Plain CT imaging after stenting revealed leakage of contrast agent, which disappeared on the second day, resulting in no clinical symptoms or neurological sequelae. Follow-up angiography studies were performed in all patients for 6–12 months (mean, 8.8). Slight asymptomatic in-stent stenosis was observed in 2 patients (16.7%), and no neurological deficits were observed in the other patients. All preoperative ischaemic symptoms completely disappeared at follow-up. ConclusionStent angioplasty is a safe and effective treatment for occlusion and stenosis of intracranial arteries in moyamoya disease.

Usefulness of Silent MRA for Evaluation of Aneurysm after Stent-Assisted Coil Embolization.

ObjectiveTo determine the usefulness of Silent MR angiography (MRA) for evaluating intracranial aneurysms treated with stent-assisted coil embolization.Materials and MethodsNinety-nine patients (101 aneurysms) treated with stent-assisted coil embolization (Neuroform atlas, 71 cases; Enterprise, 17; LVIS Jr, 9; and Solitaire AB, 4 cases) underwent time-of-flight (TOF) MRA and Silent MRA in the same session using a 3T MRI system within 24 hours of embolization. Two radiologists independently interpreted both MRA images retrospectively and rated the image quality using a 5-point Likert scale. The image quality and diagnostic accuracy of the two modalities in the detection of aneurysm occlusion were further compared based on the stent design and the site of aneurysm.ResultsThe average image quality scores of the Silent MRA and TOF MRA were 4.38 ± 0.83 and 2.78 ± 1.04, respectively (p < 0.001), with an almost perfect interobserver agreement. Silent MRA had a significantly higher image quality score than TOF MRA at the distal internal carotid artery (n = 57, 4.25 ± 0.91 vs. 3.05 ± 1.16, p < 0.001), middle cerebral artery (n = 21, 4.57 ± 0.75 vs. 2.19 ± 0.68, p < 0.001), anterior cerebral artery (n = 13, 4.54 ± 0.66 vs. 2.46 ± 0.66, p < 0.001), and posterior circulation artery (n = 10, 4.50 ± 0.71 vs. 2.90 ± 0.74, p = 0.013). Silent MRA had superior image quality score to TOF MRA in the stented arteries when using Neuroform atlas (4.66 ± 0.53 vs. 3.21 ± 0.84, p < 0.001), Enterprise (3.29 ± 1.59 vs. 1.59 ± 0.51, p = 0.003), LVIS Jr (4.33 ± 1.89 vs. 1.89 ± 0.78, p = 0.033), and Solitaire AB stents (4.00 ± 2.25 vs. 2.25 ± 0.96, p = 0.356). The interpretation of the status of aneurysm occlusion exhibited significantly higher sensitivity with Silent MRA than with TOF MRA when using the Neuroform Atlas stent (96.4% vs. 14.3%, respectively, p < 0.001) and LVIS Jr stent (100% vs. 20%, respectively, p = 0.046).ConclusionSilent MRA can be useful to evaluate aneurysms treated with stent-assisted coil embolization, regardless of the aneurysm location and type of stent used.

Mechanical revascularization using Solitaire AB device for acute limb ischemia secondary to popliteal and infrapopliteal embolic occlusion.

ObjectiveAcute limb ischemia is one of the most common arterial emergencies. The data of mechanical revascularization using Solitaire AB device coupled with thromboaspiration for the treatment of popliteal and infrapopliteal acute limb ischemia are limited. The aim of this study was to review the preliminary safety and effectiveness.MethodsWe performed a single-center retrospective review of patients with popliteal and infrapopliteal acute limb ischemia treated with Solitaire AB device coupled with thromboaspiration from February 2019 to May 2020. Adjunctive balloon angioplasty was performed to correct coexisting atherosclerotic stenosis. Technical success was defined as successful deployment of the Solitaire AB device across the occlusive segment and successful retrieval without the use of adjunctive catheter-directed thrombolysis or balloon angioplasty. Clinical success was defined as the relief of symptoms related to acute limb ischemia. Follow-up outcomes were also reviewed.ResultsThere were 15 consecutive patients who underwent 16 Solitaire AB devices. Technical success was achieved in 11 (73.3%) patients. Of the unsuccessful patients, double-stent retrievers were employed in 1 (6.7%) patient. Two patients who encountered residual clots in distal small arteries underwent adjunctive catheter-directed thrombolysis. An adjunctive balloon angioplasty was required in 1 (6.7%) patient. All patients had notable acute limb ischemia symptom relief after the procedures. Clinical success was achieved in 14 (93.3%) patients. Besides one patient encountered minor amputation, the major amputation was prevented in all patients. No device-related complications or distal embolization events were recorded during the procedures. At the follow-up of 12 months, all surviving patients remained symptom-free, the patency was achieved in 12 (80%) patients and the limb salvage was 100%.ConclusionsPreliminary outcomes suggest that mechanical revascularization using Solitaire AB device coupled with manual thromboaspiration appears to be a rapid, safe, and effective modality that appears to reduce the requirement for catheter-directed thrombolysis.Advances in knowledgeThese findings may add a promising recanalization therapy for acute embolic occlusion of the acute limb ischemia secondary to popliteal and infrapopliteal arteries.

Efficacy of Solitaire AB stent-release angioplasty in acute middle cerebral artery atherosclerosis obliterative cerebral infarction.

BACKGROUNDIn both national and international studies, the safety and effectiveness of treatment with the Solitaire stent in patients with ischemic stroke caused by acute large vessel occlusion were good, and the disability rate was significantly reduced. However, there are currently only a few reports on the differences in endovascular treatment for different etiological classifications, especially in the anterior cranial circulation, aorta atherosclerotic stenosis, and acute thrombosis.AIMTo investigate the efficacy of Solitaire AB stent-release angioplasty in patients with acute middle cerebral artery atherosclerosis obliterative cerebral infarction.METHODSTwenty-five patients with acute middle cerebral atherosclerosis obliterative cerebral infarction were retrospectively enrolled in this study from January 2017 to December 2019. The Solitaire AB stent was used to improve anterior blood flow to maintain modified cerebral infarction thrombolysis [modified thrombolysis in cerebral infarction (mTICI)] at the 2b/3 level or above, the stent was then unfolded and released.RESULTSAll 25 patients underwent successful surgery, with an average recanalization time of 23 min. One patient died of cerebral hemorrhage and cerebral herniation after the operation. The National Institutes of Health Stroke Scale (NIHSS) scores immediately after surgery (7.5 ± 5.6), at 24 h (5.5 ± 5.6) and at 1 wk (3.6 ± 6.7) compared with the preoperative NIHSS score (15.9 ± 4.4), were significantly different (P < 0.01). One case of restenosis was observed 3 mo after surgery (the stenosis rate was 50% without clinical symptoms), the modified Rankin scale scores were 0 points in 14 cases (56%), 1 point in 4 cases (16%), 2 points in 2 cases (8%), 3 points in 3 cases (12%), 4 points in 1 case (4%), and 6 points in 1 case (4%).CONCLUSIONIn acute middle cerebral artery atherosclerosis obliterative cerebral infarction, when the Solitaire AB stent is unfolded and the forward blood flow is maintained at mTICI level 2b/3 or higher, stent release may be a safe and effective treatment method; however, long-term observation and a larger sample size are required to verify these findings.

Use of Interventional Neuroradiology Devices (Solitaire AB and Cascade Net) in the Treatment of Complex Renal Aneurysms through Stent-Assisted Coil Embolisation

Introduction: The risk of rupture of true renal artery aneurysms is low but when they are bigger than 2 - 2.5 cm it increases significantly, making treatment essential. The need to use alternatives to conventional techniques in order to avoid predictable complications as coil migration is mandatory. Discussion: Routinely-used techniques in interventional neuroradiology such as flow diverters or those assisted with an occlusion balloon or stent have are suitable alternatives for complex aneurysms. Conclusion: Interventional neuroradiology devices such as the Cascade Net stent (Perflow Medical and Grupo Logsa) and Solitaire AB stent retriever (Medtronic) are valid and safe options. We describe the technique of such devices.

Endovascular Treatment of Small Wide-Neck Bifurcation Aneurysms with Single Solitaire AB Stent Technique.

We present our experience in using the single Solitaire AB stent for small wide-neck bifurcation aneurysms (WNBAs). During 18 months, 20 small (the largest width <10 mm) WNBAs were treated with the single Solitaire AB stent-assisted coiling. The patients were 12 women and 8 men, with a mean age of 52 years (range: 36-66 years). The mean aneurysm size was 4.2 mm (2-9 mm) and mean neck size was 3.9 mm (2-9 mm). Results at follow-up were graded as complete occlusion, neck remnant, or residual aneurysm. All 20 small WNBAs were adequately occluded after a single Solitaire AB stent placement. There were no procedural ruptures and no thromboembolic complications occurred. Two patients developed a transient neurological deficit. In 20 patients with angiographic follow-up at 6 months, 16 (80%) aneurysms remained adequately occluded. Clinical follow-up in the 20 patients revealed mRS 0-2 in all. Single Solitaire AB stent-assisted coil embolization for small WNBAs was safe and effective.

Assessment of Feasibility, Safety, and Efficacy of Temporary Solitaire Stent Assisted Coiling in Cases of Wide Necked Aneurysms: A Series of Case Reports

Wide-necked aneurysms require comparatively more advanced endovascular and microsurgical techniques than those required for narrow-necked aneurysms. Temporary solitaire stent-assisted coiling technique is used for treating wide neck aneurysms with the advantage of non-requirement of antiplatelet therapy to prevent in-stent thrombosis. We present a case series comprising of three case reports that were treated with temporary Solitaire stent-assisted coil embolization technique using a fully resheathable solitaire AB stent. The post-procedural angiographic and clinical outcome, including the modified Rankin Scale (mRS) score, was assessed. The Modified Rankin Score (mRS) was evaluated after clinical discharge and follow-ups. No procedure-related complications were observed. All three patients had good clinical outcomes (mRS score 0-2). The feasibility, safety, and efficacy of the Temporary solitaire stent-assisted coiling technique are much superior. It is easy, less risky, and does not require platelet inhibition therapy.

Solitaire AB stent-angioplasty for stenoses in perforator rich segments: A single-center experience.

Vascular angioplasty and stenting of middle cerebral artery (MCA) and basilar artery (BA) stenoses are associated with poor clinical outcomes and high mortality rates thought to be related to the abundance of perforating arteries in those segments. This study explores the use of Solitaire AB as an off-label vascular stent to treat stenoses in the MCA and BA. Solitaire AB stents were placed during angioplasty and stenting of MCA and BA stenoses in patients at our department between January 2015 and May 2017 with 6-36 months follow-up. Operative results were assessed by follow-up angiography and transcranial doppler after the procedure. Neurologic status was evaluated before and after treatment according to the modified Ranking Scale (mRS). A total of 32 patients were included in the study. Seventeen (53.12%) patients presented with MCA stenosis and 15 (46.87%) with BA stenosis. The 30-day rate of procedure-related complications was 3.1% (1/32). Post-stenting residual stenosis degrees ranged from 0% to 40% (mean 13.44% ± 10.66%). Mean degree of residual stenosis in 26 patients followed up by DSA was 8.64% ± 9.67%. The mRS 0-2 was achieved in all (100%) patients at 6-12 months post-procedure. Our study indicates the off-label use of Solitaire AB for stenting is effective and safe for MCA and BA stenoses with high technical success and low complications. We recommend that lesion-specific therapy with an anatomically fitted stent design enables optimal treatment for intracranial stenosis.

PHIL Migration to Internal Carotid Artery and Middle Cerebral Artery: Late Mechanical Retrieval with Solitaire AB Stent

AbstractPrecipitating hydrophobic injecting liquid (PHIL) is a novel embolic agent used in the endovascular treatment of arteriovenous malformations (AVM) and arteriovenous fistulas. Complications can occur during embolization with migration of the liquid embolic material to normal vasculature. In these cases, use of a stent retriever is an option for removal of the plug. Herein, we present the case of a patient who presented with a right occipital hemorrhage due to a ruptured occipital AVM fed by the calcarine and parieto-occipital arteries with venous drainage to the straight sinus. Embolization via the anterior circulation through the right posterior communicating artery was attempted but PHIL migrated to right internal carotid artery and middle cerebral artery due to kinking and rupture of the microcatheter. The patient developed mild left hemiparesis. When this complication occurred, no stent retriever was available at our institution and 1 day later, the Solitaire AB stent was used to remove the plug of PHIL successfully, with good reperfusion of the proximal and distal vessels. The patient improved after the procedure and was discharged home without deficit. Mechanical stent retrievers can be used in cases of migration of liquid embolic agents to normal vasculature with good clinical and radiological results.

Novel Noncrossing Y-Stent Technique Using Tapered Proximal End of a Solitaire AB Stent for Coil Embolization of Wide-Neck Bifurcation Aneurysms.

The crossing Y-stent method is one of the indispensable techniques to achieve sufficient neck coverage during coil embolization of bifurcation aneurysms with a wide neck and/or branch incorporation. However, the inevitable hourglass-like expansion of the second stent at the crossing point can result in insufficient vessel wall apposition, reduced aneurysm neck coverage, delayed endothelialization, and subsequent higher risks of acute or delayed thrombosis. It also interferes with engagement of the microcatheter into the aneurysm after stent installation. We expected to be able to reduce these disadvantages by installing a noncrossing type Y-stent using the Solitaire AB stent, which is fully retrievable with a tapered proximal end. Here we report the techniques and two successful cases.

Comparison of stent-assisted and non-stent-assisted coils in the treatment of ruptured wide-necked anterior communicating artery aneurysm in acute stage

Objective To compare the safety and efficacy of stent-assisted and non-stent-assisted coil embolization in the treatment of anterior communicating ruptured wide-necked aneurysms in acute phase. Methods The clinical data of 76 patients with anterior traffic rupture wide-necked aneurysm treated by interventional embolism from January 2014 to December 2018 were collected in the People's Hospital of Dezhou.According to whether or not stents were assisted during the operation, 76 cases were divided into stent group (41 cases) and non-stent group (35 cases). The stent group selected the Solitaire AB neurovascular remodoring device or the LVIS support for the corresponding size according to the diameter of the patients’ artery, and the non-stent group used a single catheter, a double catheter, or a balloon assist.The perioperative complications, mortality and clinical prognosis between the two groups were compared. Results There were no statistically significant differences in bleeding complications, symptomatic vasospasm, mortality and clinical prognosis between the two groups (all P>0.05). The incidence of ischemic complications in the stent group was 17.07%(7/41), which was significantly higher than that in the non-stent group[2.86%(1/35)](χ2=4.052, P<0.05). The overall complication rate of the stent group was 21.95%(9/41), which was significantly higher than 5.71%(2/35) of the non-stent group (χ2=4.021, P<0.05). Conclusion Both stent-assisted and non-stent-assisted coils can achieve good clinical results in the treatment of anterior communicating ruptured wide-necked aneurysms in acute phase.Stent-assisted embolism has a high incidence of ischemic complications and needs caution in clinical application. Key words: Intracranial aneurysm; Subarachnoid hemorrhage; Embolization, therapeutic; Tissue scaffolds; Postoperative complications; Prognosis

Analysis of factors influencing the complications of Solitaire AB stent mechanical thrombectomy in patients with acute intracranial artery occlusion

[Abstract] Objective: To investigate the influence factors of hemorrhage and stroke with retriever with Solitaire AB stent in patients with acute intracranial artery occlusion. Methods: A retrospective of 43 cases of patients with acute intracranial artery occlusion for endovascular treatment with Solitaire AB stent enrolled from March 2016 to June 2018 in our hospital, combining the characteristics of the patients of our city, through the clinical baseline data statistical analysis, complications screening of risk factors of complications. Results: There were 81.4% of patients who were dredged totally. The incidences of cerebral hemorrhage and infarction were 18.6% and 16.3%, cerebral hemorrhage group compared with control group, diabetes, blood pressure, revascularized time, NIHSS score, ASPECTS score had statistically significant differences, when infarction group compared with control group, age, opening time, ASITN_SIR score and grade of mTICI had statistically significant differences. Conclusion: Mechanical thrombectomy with Solitaire AB stent in patients with acute intracranial artery occlusion, the occurred of complications associated with various clinical factors, and the occurrence of complications seriously affect the prognosis of patients, therefore, selecting the indications strictly, and adopt individualized treatment to reduce complications.

Stent Deployment as an Emergency Alternative Treatment for Acute Stroke. Case Series

Introduction. Acute ischemic stroke due to large vessel occlusion refractory to aspiration or mechanical thrombectomy is a therapeuticchallenge. Objective. A treatment variant is in order. Methods. In the last three years, we admitted seven patients with refractory largevessel occlusions, for all of whose aspiration and mechanical thrombectomy had failed. A Solitaire AB stent was deployed as a rescuemeasure. Results. Data was retrospectively analyzed. Six out of seven patients had a good clinical outcome as measured by mTICIand mRS twelve months after the procedure. One patient died after the first follow-up visit, one month after endovascular therapy.Conclusion. Results of this small series support the role of stent deployment as a rescue measure for such challenging patients.

Combined use of the Solitaire AB stent and Navien delivery catheter for mechanical thrombectory of acute vertebrobasilar artery occlusion

Objective: To investigate the efficacy and safety of mechanical thrombectory with a tri-axial system of the solitaire AB stent through a Navien delivery catheter to treatment acute vertebrobasilar artery occlusion. Methods: The clinical data of 16 consecutive patients with acute ischemic stroke of vertebrobasilar artery occlusion treated with the Solitaire AB device from March 2016 to March 2018 in Department of Neurosurgery, the First Affiliated Hospital, Medical College of Shihezi University, were extracted and then retrospectively analyzed.Recanalization rate as well as complications after treatment were analysized. Also, neurological functions of the patients before and after operation 1 weeks, measured by National Institute of Health stroke scale (NIHSS) score were compared via t test and the clinical outcomes were assessed by modified Rankin score (mRS) at 90 days after operation. Results: There were 10 male and 6 female patients with a median age of 59 years (ranging from 45 to 78 years).Fourteen patients resulted in successfully recanalization, and 2 cases failed both of whose onset to sheath mean time were 8.5 hours.The NIHSS score at 7 days was 13±7, which was significantly decreased compared to the admission NIHSS score 24±4 (P=0.000).No symptomatic intracranial hemorrhage case was found after operation.At 90 days, 8 patients achieved good outcome (mRS 0 to 2), one patient died (mRS 6),two patients moderately seriously disabled (mRS 4).Three patients resulted in moderate outcome (mRS 3).In 3 cases of death,2 patients died due to failure in recanalization,another patient died of severe pulmonary infection. Conclusion: The results suggest that this technique of a tri-axial system used of the Solitaire AB stent through a Navien delivery catheter can effectively retrieve clots from the occlusive artery and improves functional outcome in patients with acute ischemic stroke of vertebrobasilar artery.