Incidence and outcome of procedural distal emboli using the Penumbra thrombectomy for acute stroke

Journal of Neurointerventional Surgery
Akira TodoKuo H Chao

Abstract

The Penumbra system is effective for recanalization of the primary arterial occlusion (PAO) in acute stroke. However, clinical outcomes are not as promising. The authors hypothesized that the formation of procedural distal emboli (PDE) during mechanical thrombectomy may lead to poorer patient outcomes. A retrospective review of patients with acute ischemic stroke treated with the Penumbra system was undertaken. Patients' outcome was evaluated by comparing discharge National Institute of Health stroke scale and modified Rankin score (mRS) of patients with and without PDE. Out of 20 patients reviewed, recanalization of PAO was 100%. Six patients (30%) were confirmed to have PDE, of which two died (33.3%) and one (16.7%) had mRS of 2 or less. Of the 14 patients without PDE, three died (21.4%) and six (42.9%) had mRS of 2 or less. In the patient group who survived, mean National Institute of Health stroke scale decrease was only 2.3 in patients with PDE versus a decrease of 10.6 in patients without PDE. In spite of PAO recanalization, distal emboli formed subsequent to Penumbra thrombectomy may contribute to poorer clinical outcome in acute stroke patients.

Citations

Feb 28, 2016·Journal of Neurointerventional Surgery·Ju-Yu ChuehMatthew J Gounis
Apr 27, 2017·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Gyung Ho ChungJong Myong Lee
Jan 9, 2014·Stroke; a Journal of Cerebral Circulation·Nathan W ManningRené Chapot
Dec 30, 2014·Journal of Neurointerventional Surgery·Ju-Yu ChuehMatthew J Gounis
Jul 18, 2019·Biomechanics and Modeling in Mechanobiology·Sang-Joon J LeeAnand K Ramasubramanian
May 20, 2020·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Anna Luisa KühnMatthew J Gounis
Jul 2, 2020·Journal of Neurointerventional Surgery·Seán FitzgeraldRaul G Nogueira
Dec 20, 2020·Journal of Neuroradiology. Journal De Neuroradiologie·Alejandro TomaselloMarc Ribo
Nov 13, 2020·Cardiovascular and Interventional Radiology·Ju-Yu ChuehMatthew J Gounis
Apr 10, 2021·AJNR. American Journal of Neuroradiology·S T FitzgeraldW Brinjikji
Sep 29, 2019·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Adnan I QureshiBrandi R French
Dec 16, 2021·Journal of the Royal Society, Interface·S Mostafa Mousavi J SVincent M Tutino

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