Mechanical Thrombectomy with the Penumbra 3D Separ

Authors: A Mpotsaris M Bussmeyer W Weber

Publish Date: 2013/07/28

Volume: 24, Issue: 3, Pages: 245-250

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Abstract

Intravenous recombinant human tissue plasminogen activator IV rtPA therapy has limited revascularization rates in large artery occlusions We describe the safety and effectiveness of the selfexpanding fully retrievable Separator 3D device as a component of the Penumbra System in revascularization of large artery occlusion in acute ischemic stroke The 3D secures thrombus with lesional aspiration and functions by retrieving or debulking the clotProspective singlecenter pilot study of 20 patients with an acute ischemic stroke secondary to a large artery occlusion within 9 h from symptom onset The occlusion sites were middle cerebral artery in nine patients internal carotid artery terminus in eight patients and basilar artery in three patients Thrombectomy was performed in 18 patients who had previously received IV rtPA and of these two patients had prior failed treatment with the Solitaire stent One patient had prior failed treatment with the Revive stentSuccessful revascularization defined by Thrombolysis in Cerebral Infarction grade 2b–3 was achieved in 17 of 20 85  treated vessels The median time from symptom onset to recanalization was 44 h interquartile range 38–56 h No procedural complications occurred and no symptomatic intracranial hemorrhage was observed Three 15  patients died At 90 days 50  of patients showed good functional outcome modified Rankin Scale score ≤ 2

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