Abstract Archives of the RSNA, 2010
SSE17-04
Penumbra System: A New Mechanical Thrombectomy Device for Arterial Occlusions in Acute Stroke
Scientific Formal (Paper) Presentations
Presented on November 29, 2010
Presented as part of SSE17: Neuroradiology (Interventional)
Marios Psychogios, Abstract Co-Author: Nothing to Disclose
Andreas Kreusch, Abstract Co-Author: Nothing to Disclose
Katrin Wasser, Abstract Co-Author: Nothing to Disclose
Michael Knauth MD, PhD, Presenter: Nothing to Disclose
Endovascular thrombectomy is an increasingly used treatment for arterial occlusion in acute stroke. The Penumbra System (PS) is an innovative endovascular mechanical device designed to revascularize large vessel occlusions in the intracranial circulation. The purpose of this study is to evaluate the effectiveness and neurological outcome of patients treated with the PS in the setting of acute ischemic stroke.
A total of 77 patients with acute ischemic stroke were treated and observed retrospectively in a non-randomized trial. Two certified neurologists evaluated the clinical data and two experienced neuroradiologists scored (mTIMI, TICI, Qureshi score) the angiographic images. Mean patient age was 61,2 ± 19,8 years, average NIH stroke scale (NIHSS) at hospital admission was 15,86, mean modified Rankin scale (mRS) was 4,39 and median time from symptom onset to arterial puncture was 3 hours, 54 minutes. (Target vessels: MCA 27, Carotid-T 23, ICA 9, CCA 1, Vertebrobasilar 17). In 15 cases only the PS was used for treatment, in 62 patients the mechanical revascularization was combined with i.a. and/or i.v. lysis. Follow-up data (NIHSS, mRS) were retrospectively analyzed at discharge from hospital and at release from the rehabilitation center.
Successful recanalization was achieved in 76,3% of the patients. Mean time from arterial puncture to successful thrombectomy was 43 minutes. At discharge from hospital 66,7%, after rehabilitation program (Ø 49 days) 75,8% of the surviving patients showed NIHSS improvement ≥ 4 and/or mRS ≥ 2. In total 16 of 77 (20,8 %) patients died during hospitalization, none of these deaths was device related. Related adverse events were 3 internal carotid artery dissections. Symptomatic intracranial hemorrhage was observed in 2,5% (+ 2,5 % SAB).
The PS is an effective device for mechanical revascularization. In our study successful revascularization with the PS was associated with significant improvement of functional outcome in patients experiencing ischemic stroke secondary to large vessel occlusive disease.
High recanalization rates could be achieved with the PS which led to an improvement of clinical outcome.
Psychogios, M,
Kreusch, A,
Wasser, K,
Knauth, M,
Penumbra System: A New Mechanical Thrombectomy Device for Arterial Occlusions in Acute Stroke. Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL.
http://archive.rsna.org/2010/9013922.html