Temporary endovascular bypass: Rescue technique during mechanical thrombolysis

L. Fernando Gonzalez, Pascal Jabbour, Stavropoula Tjoumakaris, Sonia Teufack, David Gordon, Aaron Dumont, Robert Rosenwasser

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

BACKGROUND: The goal of mechanical thrombolysis is to re-establish blood flow to a completely occluded artery in patients who fail intravenous thrombolytic therapy or who are outside the therapeutic window. OBJECTIVE: We present our single-institution experience with the use of temporary, partial deployment of a self-expanding intracranial stent as a rescue technique for the treatment of acute stroke. The use of the Enterprise stent represents an off-label use of a humanitarian device exemption device. METHODS: We performed a retrospective review of a prospective database of acute stroke patients treated with intra-arterial techniques at the Thomas Jefferson University Comprehensive Stroke Center from July 2009 to July 2010. RESULTS: Seven patients were included, and we obtained a 100% recanalization rate to Thrombolysis in Myocardial Infarction grade 2 and 3 with a 28% asymptomatic hemorrhagic transformation. No device-related complications were encountered. CONCLUSION: Temporary, partial deployment of a self-expanding intracranial stent as a rescue procedure is feasible, effective, and safe in the setting of endovascular intervention for acute stroke, although our experience is limited. This technique was used only as a rescue procedure when more established procedures failed.

Original languageEnglish (US)
Pages (from-to)245-252
Number of pages8
JournalNeurosurgery
Volume70
Issue number1
DOIs
StatePublished - Jan 1 2012

Keywords

  • Acute stroke
  • Mechanical thrombolysis
  • Retrievable stents

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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    Gonzalez, L. F., Jabbour, P., Tjoumakaris, S., Teufack, S., Gordon, D., Dumont, A., & Rosenwasser, R. (2012). Temporary endovascular bypass: Rescue technique during mechanical thrombolysis. Neurosurgery, 70(1), 245-252. https://doi.org/10.1227/NEU.0b013e31822e5a62