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Research ArticleNeurointervention

One-Year MR Angiographic and Clinical Follow-Up after Intracranial Mechanical Thrombectomy Using a Stent Retriever Device

F. Eugène, J.-Y. Gauvrit, J.-C. Ferré, J.-C. Gentric, A. Besseghir, T. Ronzière and H. Raoult
American Journal of Neuroradiology January 2015, 36 (1) 126-132; DOI: https://doi.org/10.3174/ajnr.A4071
F. Eugène
aFrom the Departments of Neuroradiology (F.E., J.-Y.G., J.-C.F., H.R.)
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J.-Y. Gauvrit
aFrom the Departments of Neuroradiology (F.E., J.-Y.G., J.-C.F., H.R.)
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J.-C. Ferré
aFrom the Departments of Neuroradiology (F.E., J.-Y.G., J.-C.F., H.R.)
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J.-C. Gentric
dDepartment of Neuroradiology (J.-C.G.), Centre Hospitalier Universitaire, Brest, France.
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A. Besseghir
bClinical Pharmacology (A.B.)
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T. Ronzière
cNeurology (T.R.), Centre Hospitalier Universitaire, Rennes, France
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H. Raoult
aFrom the Departments of Neuroradiology (F.E., J.-Y.G., J.-C.F., H.R.)
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    Fig 1.

    Eighteen-month MR imaging follow-up of de novo arterial stenosis and dilation (patient 2). Final post-MET angiographic run (A) of a 53-year-old patient treated for a right M1 middle cerebral artery occlusion, with 5 Solitaire passes in the superior and inferior M2 MCA branches, shows a flap in the inferior stenosis suggestive of dissection (arrow). TOF volume-rendering (B and C), MIP (D), native image (E), gadolinium-enhanced MRA (F), and high-resolution T2 (G) reveal an asymptomatic dilation (white arrow) of the superior M2 MCA branch and >50% stenosis (black arrow) of the inferior M2 MCA branch of the target vessel. Wall analysis at the stenosis is difficult on high-resolution T2 due to the vertical orientation and the size of the stenosed arterial segment.

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    Fig 2.

    Seventeen-month MR imaging follow-up of pre-existing arterial stenosis (patient 5). Final post-MET angiographic run (A) of a 77-year-old patient treated for a right M1 middle cerebral artery occlusion with 2 Solitaire passes, 1 in the superior and 1 in the inferior M2 MCA branch, shows >50% stenosis in the inferior M2 MCA division (arrow). TOF volume-rendering (B) shows persistent stenosis (worsening aspect was considered due to TOF stenosis overestimation). High-resolution T2 MRA (C) shows M2 posterior wall thickening. Atrial fibrillation was established as the etiology of the stroke.

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    Fig 3.

    Clinical follow-up. Distribution of 3-month and 1-year mRS (0–6). Values on the bar graphs indicate the number of patients.

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    Table 1:

    Baseline characteristics of patients (40 survivors at 1-year follow-up) and recanalization therapy

    Population (n = 40)ACO (n = 30)PCO (n = 10)
    Basic data
        Age (yr), mean (SD; range)57.4 (15.2; 27–79)60 (14.9; 35–79)49.6 (14.1; 27–71)
        Female sex (%)12 (30%)102
        Pretreatment NIHSS score, mean (SD)15.9 (5.5)16.1 (4.9)15.5 (7.3)
    Premorbid status
        Charlson Index ≥3 (%)4 (10)31
    Etiology
        TOAST I—large-artery atherosclerosis1055
        TOAST II—cardiac embolism16142
        TOAST IV—other determined etiology431
        TOAST V—undetermined etiology972
    Initial imaging
        CT883
        MRI32257
        DWI-ASPECTS <555
    Target-vessel territories
        M1 segment of the MCA2929
        M2 segment of the MCA11
        Basilar artery1010
    Recanalization strategy
        Stand-alone21147
        Bridging1082
        Rescue981
    Endovascular therapy
        Solitaire passes, mean (range)2.0 (1–7)1.9 (1–4)2.4 (1–7)
        Procedural time (min), mean (SD, range)75 (40, 30–189)69 (30, 30–150)96 (54, 30–189)
        Time to recanalization (min), mean (SD, range)322 (127, 127–793)288 (90, 67–430)421 (170, 150–793)
    • Note:—ACO indicates anterior circulation occlusion; PCO, posterior circulation occlusion.

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    Table 2:

    Clinical outcomes at 1-year follow-up

    Population (n = 48)ACOPCO
    mRS 0–1 (%)25 (52.1)17/34 (50.0)8/14 (57.1)
    mRS 0–2 (%)30 (62.5)22/34 (64.7)8/14 (57.1)
    mRS 3 (%)3 (6.2)2/34 (5.9)1/14 (7.1)
    mRS 4–5 (%)7 (14.6)6/34 (17.6)1/14 (7.1)
    mRS 6 (mortality) (%)8/48 (16.7)4/34 (11.8)4/14 (28.6)
    SF-36 PCS (mean) (median, range)51.2 (52.8, 5.6–100)49.9 (51.9, 5.6–100)56.3 (60.6, 32.9–71.0)
    SF-36 MCS (mean) (median, range)51.4 (47.1, 4.0–98.8)50.4 (47.1, 4.0–98.8)53.9 (48.6, 32.3–81.1)
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American Journal of Neuroradiology: 36 (1)
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Cite this article
F. Eugène, J.-Y. Gauvrit, J.-C. Ferré, J.-C. Gentric, A. Besseghir, T. Ronzière, H. Raoult
One-Year MR Angiographic and Clinical Follow-Up after Intracranial Mechanical Thrombectomy Using a Stent Retriever Device
American Journal of Neuroradiology Jan 2015, 36 (1) 126-132; DOI: 10.3174/ajnr.A4071

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One-Year MR Angiographic and Clinical Follow-Up after Intracranial Mechanical Thrombectomy Using a Stent Retriever Device
F. Eugène, J.-Y. Gauvrit, J.-C. Ferré, J.-C. Gentric, A. Besseghir, T. Ronzière, H. Raoult
American Journal of Neuroradiology Jan 2015, 36 (1) 126-132; DOI: 10.3174/ajnr.A4071
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