The combined use of mechanical thrombectomy devices is feasible for treating acute carotid terminus occlusion

Acta Neurochir (Wien). 2013 Apr;155(4):635-41. doi: 10.1007/s00701-013-1649-5. Epub 2013 Feb 23.


Background: Mechanical thrombectomy devices have recently been developed and approved for recanalization of intracranial arterial occlusion. Here, we investigated the feasibility of combined stent-assisted and clot aspiration mechanical thrombectomy for effective recanalization of acute carotid terminus occlusion (CTO).

Methods: Ten consecutive patients with acute ischemic stroke secondary to CTO who underwent intra-arterial (IA) treatment with both stent retrieval and negative-pressured clot aspiration systems were enrolled. Periprocedural and radiologic findings and clinical outcomes were evaluated.

Results: The median age was 69 years (range, 47-86 years), and the median initial NIHSS score was 17.5 (range, 12-33). Mechanical thrombectomy was performed using a combination of the Solitaire stents and Penumbra system. Thrombolysis in cerebral ischemia [TICI] grade II-III was achieved in eight patients (80.0 %); complete recanalization of the CTO (TICI III) was achieved in three of those patients. Any type of intracranial hemorrhages occurred in four patients (40.0 %), but parenchymal hematoma type 2 was not observed. Four patients died within 3 months (40.0 %).

Conclusions: Combined mechanical thrombectomy treatment was effective for recanalization of acute CTO. The combination of Solitaire and Penumbra devices can be considered as a treatment option for CTO.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Brain Ischemia / surgery*
  • Carotid Artery Diseases / surgery*
  • Cerebral Angiography / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Stroke / surgery*
  • Thrombectomy / instrumentation*
  • Treatment Outcome