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<meta name="DC.Title" content="Mechanical Embolectomy for Acute Ischemic Stroke in the Anterior Cerebral Circulation: The Gothenburg Experience during 2000–2011" />
<meta name="DC.Identifier" content="10.3174/ajnr.A3997" />
<meta name="DC.Date" content="2014-10-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Intra-arterial treatment of proximal occlusions in the cerebral circulation have become an important tool in the management of acute ischemic stroke. Our goal was to evaluate the safety and efficacy of intra-arterial acute ischemic stroke treatment performed in our institution in consecutive patients with anterior circulation occlusion during 2000–2011.

MATERIALS AND METHODS: We identified, in our data base, 156 consecutive cases with anterior acute ischemic stroke treated intra-arterially during 2000–2011. Stroke severity was defined according to the National Institutes of Health Stroke Scale, the results of the procedure were defined according to the modified Thrombolysis in Cerebral Infarction score, and clinical outcome was defined according to the modified Rankin scale, with favorable outcome ≤2 at 90 days.

RESULTS: The mean admission NIHSS score was 19.4 (median, 20), with a mean time from stroke onset to groin puncture of 197 minutes (median, 171 minutes). The embolectomy tool of choice was the Amplatz GooseNeck snare (83%). Successful recanalization (modified TICI 2b +3) was seen in 74% of cases. A mRS ≤ 2 at 90 days was seen in 42% with a mortality rate of 17% and symptomatic intracerebral hemorrhage in 4%.

CONCLUSIONS: A high recanalization rate was obtained with the Amplatz GooseNeck snare without any device-related complications. Favorable outcome, mortality, and symptomatic intracerebral hemorrhage are comparable with results of newer embolectomy devices.

AIS
:   acute ischemic stroke
mTICI
:   modified Thrombolysis in Cerebral Infarction
sICH
:   symptomatic intracerebral hemorrhage" />
<meta name="DC.Contributor" content="A. Rentzos" />
<meta name="DC.Contributor" content="C. Lundqvist" />
<meta name="DC.Contributor" content="J.-E. Karlsson" />
<meta name="DC.Contributor" content="V. Vilmarsson" />
<meta name="DC.Contributor" content="K. Schnabel" />
<meta name="DC.Contributor" content="G. Wikholm" />
<meta name="article:published_time" content="2014-10-01" />
<meta name="article:section" content="Interventional" />
<meta name="citation_title" content="Mechanical Embolectomy for Acute Ischemic Stroke in the Anterior Cerebral Circulation: The Gothenburg Experience during 2000–2011" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Intra-arterial treatment of proximal occlusions in the cerebral circulation have become an important tool in the management of acute ischemic stroke. Our goal was to evaluate the safety and efficacy of intra-arterial acute ischemic stroke treatment performed in our institution in consecutive patients with anterior circulation occlusion during 2000–2011.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;We identified, in our data base, 156 consecutive cases with anterior acute ischemic stroke treated intra-arterially during 2000–2011. Stroke severity was defined according to the National Institutes of Health Stroke Scale, the results of the procedure were defined according to the modified Thrombolysis in Cerebral Infarction score, and clinical outcome was defined according to the modified Rankin scale, with favorable outcome ≤2 at 90 days.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;The mean admission NIHSS score was 19.4 (median, 20), with a mean time from stroke onset to groin puncture of 197 minutes (median, 171 minutes). The embolectomy tool of choice was the Amplatz GooseNeck snare (83%). Successful recanalization (modified TICI 2b +3) was seen in 74% of cases. A mRS ≤ 2 at 90 days was seen in 42% with a mortality rate of 17% and symptomatic intracerebral hemorrhage in 4%.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;A high recanalization rate was obtained with the Amplatz GooseNeck snare without any device-related complications. Favorable outcome, mortality, and symptomatic intracerebral hemorrhage are comparable with results of newer embolectomy devices.&lt;/p&gt;" />
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<meta name="twitter:title" content="Mechanical Embolectomy for Acute Ischemic Stroke in the Anterior Cerebral Circulation: The Gothenburg Experience during 2000–2011" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Intra-arterial treatment of proximal occlusions in the cerebral circulation have become an important tool in the management of acute ischemic stroke. Our goal was to evaluate the safety and efficacy of intra-arterial acute ischemic stroke treatment performed in our institution in consecutive patients with anterior circulation occlusion during 2000–2011.

MATERIALS AND METHODS: We identified, in our data base, 156 consecutive cases with anterior acute ischemic stroke treated intra-arterially during 2000–2011. Stroke severity was defined according to the National Institutes of Health Stroke Scale, the results of the procedure were defined according to the modified Thrombolysis in Cerebral Infarction score, and clinical outcome was defined according to the modified Rankin scale, with favorable outcome ≤2 at 90 days.

RESULTS: The mean admission NIHSS score was 19.4 (median, 20), with a mean time from stroke onset to groin puncture of 197 minutes (median, 171 minutes). The embolectomy tool of choice was the Amplatz GooseNeck snare (83%). Successful recanalization (modified TICI 2b +3) was seen in 74% of cases. A mRS ≤ 2 at 90 days was seen in 42% with a mortality rate of 17% and symptomatic intracerebral hemorrhage in 4%.

CONCLUSIONS: A high recanalization rate was obtained with the Amplatz GooseNeck snare without any device-related complications. Favorable outcome, mortality, and symptomatic intracerebral hemorrhage are comparable with results of newer embolectomy devices.

AIS
:   acute ischemic stroke
mTICI
:   modified Thrombolysis in Cerebral Infarction
sICH
:   symptomatic intracerebral hemorrhage" />
<meta name="og-title" property="og:title" content="Mechanical Embolectomy for Acute Ischemic Stroke in the Anterior Cerebral Circulation: The Gothenburg Experience during 2000–2011" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/35/10/1936" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Intra-arterial treatment of proximal occlusions in the cerebral circulation have become an important tool in the management of acute ischemic stroke. Our goal was to evaluate the safety and efficacy of intra-arterial acute ischemic stroke treatment performed in our institution in consecutive patients with anterior circulation occlusion during 2000–2011.

MATERIALS AND METHODS: We identified, in our data base, 156 consecutive cases with anterior acute ischemic stroke treated intra-arterially during 2000–2011. Stroke severity was defined according to the National Institutes of Health Stroke Scale, the results of the procedure were defined according to the modified Thrombolysis in Cerebral Infarction score, and clinical outcome was defined according to the modified Rankin scale, with favorable outcome ≤2 at 90 days.

RESULTS: The mean admission NIHSS score was 19.4 (median, 20), with a mean time from stroke onset to groin puncture of 197 minutes (median, 171 minutes). The embolectomy tool of choice was the Amplatz GooseNeck snare (83%). Successful recanalization (modified TICI 2b +3) was seen in 74% of cases. A mRS ≤ 2 at 90 days was seen in 42% with a mortality rate of 17% and symptomatic intracerebral hemorrhage in 4%.

CONCLUSIONS: A high recanalization rate was obtained with the Amplatz GooseNeck snare without any device-related complications. Favorable outcome, mortality, and symptomatic intracerebral hemorrhage are comparable with results of newer embolectomy devices.

AIS
:   acute ischemic stroke
mTICI
:   modified Thrombolysis in Cerebral Infarction
sICH
:   symptomatic intracerebral hemorrhage" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node13755--5" data-node-nid="13755" id="top-node-13755--6688810286" data-pisa="ajnr;35/10/1936" data-pisa-master="ajnr;ajnr.A3997" data-apath="/ajnr/35/10/1936.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
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      <h1 class="highwire-cite-title" id="page-title">Mechanical Embolectomy for Acute Ischemic Stroke in the Anterior Cerebral Circulation: The Gothenburg Experience during 2000–2011</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">A. Rentzos</span>, <span class="highwire-citation-author" data-delta="1">C. Lundqvist</span>, <span class="highwire-citation-author" data-delta="2">J.-E. Karlsson</span>, <span class="highwire-citation-author" data-delta="3">V. Vilmarsson</span>, <span class="highwire-citation-author" data-delta="4">K. Schnabel</span> and <span class="highwire-citation-author" data-delta="5">G. Wikholm</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">October 2014,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">35 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1936-1941; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A3997 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-13755--6688810286" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">A. Rentzos </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Interventional and Diagnostic Neuroradiology (A.R., V.V., K.S., G.W.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.%2BRentzos%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Rentzos%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AA.%2BRentzos%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">C. Lundqvist </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Neurology (C.L., J.-E.K.), Sahlgrenska University Hospital, Gothenburg, Sweden.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=C.%2BLundqvist%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Lundqvist%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AC.%2BLundqvist%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">J.-E. Karlsson </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Neurology (C.L., J.-E.K.), Sahlgrenska University Hospital, Gothenburg, Sweden.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.-E.%2BKarlsson%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Karlsson%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AJ.-E.%2BKarlsson%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">V. Vilmarsson </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Interventional and Diagnostic Neuroradiology (A.R., V.V., K.S., G.W.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=V.%2BVilmarsson%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Vilmarsson%20V&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AV.%2BVilmarsson%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">K. Schnabel </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Interventional and Diagnostic Neuroradiology (A.R., V.V., K.S., G.W.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=K.%2BSchnabel%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Schnabel%20K&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AK.%2BSchnabel%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">G. Wikholm </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Interventional and Diagnostic Neuroradiology (A.R., V.V., K.S., G.W.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=G.%2BWikholm%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Wikholm%20G&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AG.%2BWikholm%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div></div></div>  </div>

  
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<p id="p-2"><strong>BACKGROUND AND PURPOSE:</strong> Intra-arterial treatment of proximal occlusions in the cerebral circulation have become an important tool in the management of acute ischemic stroke. Our goal was to evaluate the safety and efficacy of intra-arterial acute ischemic stroke treatment performed in our institution in consecutive patients with anterior circulation occlusion during 2000–2011.</p>
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<p id="p-3"><strong>MATERIALS AND METHODS:</strong> We identified, in our data base, 156 consecutive cases with anterior acute ischemic stroke treated intra-arterially during 2000–2011. Stroke severity was defined according to the National Institutes of Health Stroke Scale, the results of the procedure were defined according to the modified Thrombolysis in Cerebral Infarction score, and clinical outcome was defined according to the modified Rankin scale, with favorable outcome ≤2 at 90 days.</p>
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<p id="p-4"><strong>RESULTS:</strong> The mean admission NIHSS score was 19.4 (median, 20), with a mean time from stroke onset to groin puncture of 197 minutes (median, 171 minutes). The embolectomy tool of choice was the Amplatz GooseNeck snare (83%). Successful recanalization (modified TICI 2b +3) was seen in 74% of cases. A mRS ≤ 2 at 90 days was seen in 42% with a mortality rate of 17% and symptomatic intracerebral hemorrhage in 4%.</p>
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<p id="p-5"><strong>CONCLUSIONS:</strong> A high recanalization rate was obtained with the Amplatz GooseNeck snare without any device-related complications. Favorable outcome, mortality, and symptomatic intracerebral hemorrhage are comparable with results of newer embolectomy devices.</p>
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<h2>ABBREVIATIONS:</h2>
<dl id="def-list-1"><dt id="def-item-1">AIS<span class="def-item-dt-sep"></span></dt><dd>acute ischemic stroke<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">mTICI<span class="def-item-dt-sep"></span></dt><dd>modified Thrombolysis in Cerebral Infarction<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">sICH<span class="def-item-dt-sep"></span></dt><dd>symptomatic intracerebral hemorrhage</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2014 by American Journal of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/35/10/1936.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Rentzos</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">C.</span> <span class="nlm-surname">Lundqvist</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">J.-E.</span> <span class="nlm-surname">Karlsson</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">V.</span> <span class="nlm-surname">Vilmarsson</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">K.</span> <span class="nlm-surname">Schnabel</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">G.</span> <span class="nlm-surname">Wikholm</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Oct 2014, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">35 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1936-1941; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A3997 </span></div>
  
  
  
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      <div class="highwire-cite-title">Mechanical Embolectomy for Acute Ischemic Stroke in the Anterior Cerebral Circulation: The Gothenburg Experience during 2000–2011</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Rentzos</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">C.</span> <span class="nlm-surname">Lundqvist</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">J.-E.</span> <span class="nlm-surname">Karlsson</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">V.</span> <span class="nlm-surname">Vilmarsson</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">K.</span> <span class="nlm-surname">Schnabel</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">G.</span> <span class="nlm-surname">Wikholm</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Oct 2014, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">35 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1936-1941; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A3997 </span></div>
  
  
  
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