Wiebke Kurre MD, Abstract Co-Author: Speakers Bureau, Johnson & Johnson

Marta Aguilar-Perez MD, Abstract Co-Author: Nothing to Disclose

Diana Horvath MD, Abstract Co-Author: Nothing to Disclose

Elisabeth Schmid, Abstract Co-Author: Nothing to Disclose

Hansjorg Bazner PhD, Abstract Co-Author: Nothing to Disclose

Hans Henkes MD, Presenter: Nothing to Disclose

Nowadays mTE is the preferred strategy in endovascular management of embolic cerebral vessel occlusions. Most emboli can be retrieved with stent like devices but failure may still occur. In addition mTE of peripheral branches supplying eloquent brain tissue carries a high procedural risk. In these occasions thrombus stenting may serve as a rescue therapy.

We retrospectively selected consecutive cases of thrombus stenting with Enterprise® after failure of mTE or in distal vessel occlusion. Treatments were performed between January 2008 and February 2012. Efficacy of recanalization was measured using the thrombolysis in cerebral infarction (TICI) score. TICI 2b and 3 were regarded as technical success. To assess procedural safety we reported the rate of intracranial hemorrhages. Symptomatic hemorrhages were distinguished using the ECASS III definition. Available follow up angiographies were analyzed for stent patency.

Thrombus stenting was performed in 59 patients using 70 Enterprise® to treat 67 target vessels. Fifty vessels were located in the anterior and 17 in the posterior circulation. TICI 2b and 3 score of the territory distal to the stented segment was achieved in 47 vessels (70%). The rate of any hemorrhage on follow up imaging was 28% with 11.8% being clinically symptomatic. Three intraprocedural hemorrhages occurred most likely due to wire perforation. Follow up angiography was performed in 24 patients showing 2 clinically asymptomatic stent occlusions.

Thrombus stenting using Enterprise® is a feasible method to recanalize cerebral vessels when mTE is inappropriate or failed. In terms of safety the rate of symptomatic hemorrhage appears acceptable given the poor prognosis with persistent vessel occlusion.

The Enterprise; intracranial stent broadens the armamentarium for endovascular;recanalization of embolic vessel occlusion as second line treatment after failure of mTE or in cases inappropriate for mT

Kurre, W, Aguilar-Perez, M, Horvath, D, Schmid, E, Bazner, H, Henkes, H, Thrombus Stenting after Failed Mechanical Thrombectomy (mTE) and in Distal Cerebral Vessel Occlusion Using the Enterprise® Stent - Experience in 59 Cases.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12037465.html