One-year MR angiographic and clinical follow-up after intracranial mechanical thrombectomy using a stent retriever device

• Published in: American journal of neuroradiology : AJNR 2015-01, Vol.36 (1), p.126-132
• Main Authors: Eugène, F, Gauvrit, J-Y, Ferré, J-C, Gentric, J-C, Besseghir, A, Ronzière, T, Raoult, H
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Cerebral Angiography; Cerebral Arteries - diagnostic imaging; Female; Follow-Up Studies; Humans; Interventional; Life Sciences; Male; Middle Aged; Neurons and Cognition; Quality of Life; Stroke - diagnostic imaging; Stroke - surgery; Thrombectomy - adverse effects; Thrombectomy - instrumentation; Thrombectomy - methods; Treatment Outcome
• ISSN: 0195-6108; 1936-959X
• DOI: 10.3174/ajnr.A4071

Little is known about the consequences of arterial wall damage that may be due to mechanical endovascular thrombectomy. Our aim was to perform 1-year MR angiographic and clinical follow-up of patients treated with mechanical endovascular thrombectomy using the Solitaire device. Patients with stroke treated between August 2010 and July 2012 were prospectively evaluated with a minimum follow-up of 1 year after mechanical endovascular thrombectomy. Angiographic follow-up was performed on a 3T MR imaging scanner and included intracranial artery TOF MRA and supra-aortic artery gadolinium-enhanced MRA. Images were assessed to detect arterial abnormalities (stenosis, occlusion, dilation) and were compared with the final post-mechanical endovascular thrombectomy run to differentiate delayed and pre-existing abnormalities. Clinical evaluation was performed with the mRS and the 36-Item Short-Form Health Survey questionnaire quality-of-life scale. Thirty-nine patients were angiographically assessed at the mean term of 19 ± 4 months. MRA showed intracranial artery abnormalities in 10 patients, including 5 delayed intracranial artery abnormalities in 4 patients (4 stenoses and 1 dilation), 4 cases of pre-existing intracranial artery stenosis, and 2 occlusions. Pre-existing etiologic cervical artery stenosis or occlusion was observed in 2 patients. All these patients remained asymptomatic during the follow-up period. A significant clinical improvement was observed at 1-year follow-up in comparison with 3-month follow-up (P < .0001), with a good outcome achieved in 62.5% of patients and an acceptable quality of life restored. One-year follow-up identifies delayed asymptomatic arterial abnormalities in patients treated with the Solitaire device.