Stent Retriever Thrombectomy with Mindframe Capture LP in Isolated M2 Occlusions

• Published in: Clinical neuroradiology (Munich) 2020-03, Vol.30 (1), p.51-58
• Main Authors: Dobrocky, Tomas, Bellwald, Sebastian, Kurmann, Rebekka, Piechowiak, Eike I., Kaesmacher, Johannes, Mosimann, Pascal J., Zibold, Felix, Jung, Simon, Arnold, Marcel, Fischer, Urs, Gralla, Jan, Mordasini, Pasquale
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Brain - surgery; Brain Ischemia - complications; Brain Ischemia - surgery; Care and treatment; Female; Hemorrhage; Humans; Ischemia; Male; Medicine; Medicine & Public Health; Middle Aged; Neurology; Neuroradiology; Neurosurgery; Original Article; Prospective Studies; Retrospective Studies; Stent (Surgery); Stents; Stroke; Stroke (Disease); Stroke - etiology; Stroke - surgery; Thrombectomy - instrumentation; Thrombectomy - methods; Treatment Outcome
• ISSN: 1869-1439; 1869-1447
• DOI: 10.1007/s00062-018-0739-4

Background and Purpose Mechanical thrombectomy is an effective recanalization technique in acute ischemic stroke patients with large vessel occlusions; however, it is unclear to what extent stent retriever thrombectomy may be applicable to occlusions of smaller peripheral cerebral vessels. The outcome of patients with isolated M2 occlusions treated with the Mindframe Capture low profile (LP) stent retriever was reviewed. Material and Methods A retrospective review of prospectively collected data on all consecutive patients treated for isolated M2 occlusions between June 2013 and December 2017 using the Mindframe Capture LP was performed. Technical aspects of the recanalization procedure, recanalization rate, complication rate, and clinical outcome were analyzed. Results Mechanical thrombectomy with the Mindframe Capture LP was performed in 38 patients (median age 79 years) with an isolated M2 occlusion. The median National Institutes of Health Stroke Scale (NIHSS) score on admission was 7.5 (interquartile range, IQR 5–12) and successful reperfusion modified Thrombolysis in Cerebral Infarction (mTICI 2b or 3) was achieved in 28 patients (74%). A compensated/adjusted modified Rankin Scale (mRS) 0–2 at 3 months was observed in 65% when taking pre-stroke disability into account. Symptomatic intracranial hemorrhage (sICH) occurred in 1 patient (2.6%). Asymptomatic intracranial hemorrhage (aICH) was noted in 8 patients (21%) and a small subarachnoid hemorrhage (SAH) in the immediate vicinity of the target vessel was apparent in 8 patients (21%). Conclusion The Mindframe Capture LP is a technically effective thrombectomy device for the treatment of isolated M2 occlusions. The lower profile of the device is advantageous when targeting peripheral intracranial occlusions.