Kai Kallenberg MD, Presenter: Speakers Bureau, Acandis GmbH & Co KG

Michael Knauth MD, PhD, Abstract Co-Author: Speakers Bureau, Penumbra, Inc Speakers Bureau, Siemens AG Speakers Bureau, Acandis GmbH & Co KG Speakers Bureau, Johnson & Johnson

Bernd Turowski, Abstract Co-Author: Nothing to Disclose

Laszlo Solymosi, Abstract Co-Author: Nothing to Disclose

Olav Jansen MD, PhD, Abstract Co-Author: Nothing to Disclose

Sebastian Arnold, Abstract Co-Author: Nothing to Disclose

Martin Schumacher, Abstract Co-Author: Nothing to Disclose

Ischemic stroke is the leading cause of disability in developed countries and represents a turning point in the life of those affected and their families – direct and indirect costs are enormous. Early revascularization is a positive predictor of good clinical outcome (Rha JH and Saver JL, Stroke 2007). However, the recommended and approved therapy, the intravenous lysis is often ineffective, esp. at thrombuslengths > 8mm (Riedel CH et al, Stroke 2011) and has dangerous side effects. In addition to approved thrombectomy tools stent-like devices recently rendered excellent results (Machi P et al, J NeuroIntervent Surg 2012). The present study reports the first experience with a new thrombectomy tool: Aperio®, Acandis Pforzheim / Germany.

The Aperio® thrombectomy device was used in the treatment of acute ischemic stroke by interventional neuroradiologists in 7 different hospitals: using a microcatheter the device was placed and deployed at the site of vessel occlusion. Subsequently, the device and consecutively the thrombus was removed applying aspiration.

A total of 48 patients was treated - in the majority anterior circulation strokes mainly in the left hemisphere. In all cases, the target vessel was reached and the device deployed in its intended location - already restoring antegrade blood-flow in most of the cases. After the first passage blood flow was completely restored in 21% (TICI 3) –finally, in 87% the target vessel was successfully recanalized (TICI 2/3), 11% remained occluded (TICI 0). The mean procedure duration was 35 minutes. Preparation, visibility under fluoroscopy, and handling of the Aperio® device and the supplied microcatheter were described as good or very good by the users in about 90%. Only in one case, a device-related clinically significant adverse event appeared. The first, very limited clinical results were good: 7/11 patients rendered a modified Rankin Scale ≤ 2 at discharge.

Aperio® seems a promising tool for thrombectomy in the treatment of acute stroke: preparation and handling was felt to be easy, a high rate of arterial recanalization was achieved and the use appeared safe.

Ischemic stroke is the leading cause of disability in developed countries. Intravenous lysis often is ineffective. New strategies are desirable. Recent reports favor stent-like devices like Aperio.

Kallenberg, K, Knauth, M, Turowski, B, Solymosi, L, Jansen, O, Arnold, S, Schumacher, M, Mechanical Revascularization in the Treatment of Acute Stroke: Aperio® A New Thrombectomy Device - Work in Progress.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12031053.html