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PT  - JOURNAL ARTICLE
AU  - Klisch, J.
AU  - Sychra, V.
AU  - Strasilla, C.
AU  - Taschner, C.A.
AU  - Reinhard, M.
AU  - Urbach, H.
AU  - Meckel, S.
TI  - Double Solitaire Mechanical Thrombectomy in Acute Stroke: Effective Rescue Strategy for Refractory Artery Occlusions?
AID  - 10.3174/ajnr.A4133
DP  - 2015 Mar 01
TA  - American Journal of Neuroradiology
PG  - 552--556
VI  - 36
IP  - 3
4099  - http://www.ajnr.org/content/36/3/552.short
4100  - http://www.ajnr.org/content/36/3/552.full
SO  - Am. J. Neuroradiol.2015 Mar 01; 36
AB  - BACKGROUND AND PURPOSE: Mechanical thrombectomy by using a single stent retriever system has demonstrated high efficacy for recanalization of large-artery occlusions in acute stroke. We aimed to evaluate the feasibility, safety, and efficacy of a novel double Solitaire stent retriever technique as an escalating treatment for occlusions that are refractory to first-line single stent retriever mechanical thrombectomy. MATERIALS AND METHODS: All patients treated with the double stent retriever technique by using the Solitaire system were retrospectively selected from 2 large neurointerventional centers. Time to recanalization, angiographic (TICI) and clinical outcomes (mRS), and complications were assessed. RESULTS: Ten patients (median NIHSS score, 16; mean age, 70 years) with MCA M1 segment (n = 5) and terminal ICA (n = 5 including 2 ICA tandem) occlusions were included. Prior single stent retriever mechanical thrombectomy had been performed in 9 patients (median number of passes, 3). Median time to recanalization was 60 minutes (interquartile range, 45–87 minutes). Procedure-related complications occurred in 1 patient; overall mortality was 20%. Recanalization of the target vessel (TICI 2b/3) was achieved in 80%. Good clinical outcome (mRS 0–2) was 50%. CONCLUSIONS: In this preliminary feasibility study, the double Solitaire stent retriever technique proved to be an effective method for recanalization of anterior circulation large-artery occlusions refractory to standard stent retriever mechanical thrombectomy. DACdistal-access catheterICATinternal carotid artery terminusMTmechanical thrombectomySRstent retriever