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Journal articles on the topic 'Thrombectomy'

Author: Grafiati

Published: 4 June 2021

Last updated: 18 June 2025

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1

Dumont, T. M., M. Mokin, G. C. Sorkin, E. I. Levy, and A. H. Siddiqui. "Aspiration thrombectomy in concert with stent thrombectomy." Case Reports 2013, jul12 1 (2013): bcr2012010624. http://dx.doi.org/10.1136/bcr-2012-010624.

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2

Dumont, Travis M., Maxim Mokin, Grant C. Sorkin, Elad I. Levy, and Adnan H. Siddiqui. "Aspiration thrombectomy in concert with stent thrombectomy." Journal of NeuroInterventional Surgery 6, no. 4 (2013): e26-e26. http://dx.doi.org/10.1136/neurintsurg-2012-010624.rep.

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3

Evans, Matthew C., and Anbukarasi Maran. "Aspiration Thrombectomy." Interventional Cardiology Clinics 10, no. 3 (2021): 317–22. http://dx.doi.org/10.1016/j.iccl.2021.04.001.

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4

Lauzier, David C., Maria M. Galardi, Kristin P. Guilliams, et al. "Pediatric Thrombectomy." Stroke 52, no. 4 (2021): 1511–19. http://dx.doi.org/10.1161/strokeaha.120.032268.

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Endovascular thrombectomy has played a major role in advancing adult stroke care and may serve a similar role in pediatric stroke care. However, there is a need to develop better evidence and infrastructure for pediatric stroke care. In this work, we review 2 experienced pediatric endovascular thrombectomy programs and examine key design features in both care environments, including a formalized protocol and workflow, integration with an adult endovascular thrombectomy workflow, simplification and automation of workflow steps, pediatric adaptations of stroke imaging, advocacy of pediatric stroke care, and collaboration between providers, among others. These essential features transcend any single hospital environment and may provide an important foundation for other pediatric centers that aim to enhance the care of children with stroke.

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5

Ojiro, Masataka. "Venous Thrombectomy." Japanese Journal of Phlebology 11, no. 3 (2000): 271–76. http://dx.doi.org/10.7134/phlebol.11-3-271.

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6

Mullen, Michael T., and Seemant Chaturvedi. "Endovascular thrombectomy." Neurology 88, no. 22 (2017): 2074–75. http://dx.doi.org/10.1212/wnl.0000000000003993.

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7

Nicolaides, A., J. Fareed, A. K. Kakkar, et al. "Surgical Thrombectomy." Clinical and Applied Thrombosis/Hemostasis 19, no. 2 (2013): 205–6. http://dx.doi.org/10.1177/1076029612474840q.

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Wu, Yuefei, Congguo Yin, Jianhong Yang, Lin Jiang, Mark W. Parsons, and Longting Lin. "Endovascular Thrombectomy." Stroke 49, no. 11 (2018): 2783–85. http://dx.doi.org/10.1161/strokeaha.118.022919.

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Balan, Prakash, and H. Vernon Anderson. "Aspiration Thrombectomy." Journal of the American College of Cardiology 62, no. 16 (2013): 1419–20. http://dx.doi.org/10.1016/j.jacc.2013.03.069.

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Hung, Chi-Sheng, Mao-Shin Lin, Ying-Hsien Chen, Ching-Chang Huang, Hung-Yuan Li, and Hsien-Li Kao. "Aspiration Thrombectomy." Journal of the American College of Cardiology 65, no. 9 (2015): 960–61. http://dx.doi.org/10.1016/j.jacc.2014.10.077.

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De Rosa, Salvatore, Gianluca Caiazzo, Daniele Torella, and Ciro Indolfi. "Aspiration Thrombectomy." Journal of the American College of Cardiology 63, no. 19 (2014): 2052–53. http://dx.doi.org/10.1016/j.jacc.2013.12.038.

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Powers, Eric R. "Aspiration Thrombectomy." JACC: Cardiovascular Interventions 9, no. 19 (2016): 2012–13. http://dx.doi.org/10.1016/j.jcin.2016.07.037.

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13

de Castro Afonso, Luís Henrique, Guilherme Borghini Pazuello, Guilherme Seizem Nakiri, et al. "Thrombectomy for M2 occlusions and the role of the dominant branch." Interventional Neuroradiology 25, no. 6 (2019): 697–704. http://dx.doi.org/10.1177/1591019919847693.

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Introduction The benefits of thrombectomy for occlusion of M2 segments remain controversial. The aim of this study is to assess thrombectomy’s efficacy and safety in patients with M2 segment occlusion and associations between occlusion sites and anatomic variations of M1 division. Materials and methods A prospective series of 30 patients with acute ischemic stroke (AIS) resulting from M2 segment occlusion of the middle cerebral artery (MCA) who underwent thrombectomy was analyzed. The primary endpoint was assessed by the Extended Treatment in Cerebral Infarction scale (eTICI). The secondary endpoints were the incidence of symptomatic hemorrhagic transformation (sICH), mortality and good functional outcome at three months. Results The mean patient age was 69.2 years. The mean National Institutes Health Stroke Scale score (NIHSS) upon hospital admission was 16. The recanalization rates were eTICI 2b/3 in 90% and 2c/3 in 60% of the patients. Total recanalization of the M2 branch was achieved in 53% of patients. sICH incidence was 6.6%, the mortality rate was 30%, and a good functional outcome (mRS ≤2) was observed in 50% of the patients. Twenty-seven patients (90%) had a dominant M2 branch and all were occluded. Regarding the site of M2 occlusions, 74% of patients had proximal M2 occlusions. Conclusions Thrombectomy appears to be a safe and effective method for the treatment of acute M2 segment occlusions of the MCA. Most of the cases had a dominant M2 branch, and all of them were occluded. Larger studies are needed to verify the benefits of thrombectomy for different settings of M2 occlusions.

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Kim, Yong-Won, Seungnam Son, Dong-Hun Kang, Yang-Ha Hwang, and Yong-Sun Kim. "Endovascular thrombectomy for M2 occlusions: comparison between forced arterial suction thrombectomy and stent retriever thrombectomy." Journal of NeuroInterventional Surgery 9, no. 7 (2016): 626–30. http://dx.doi.org/10.1136/neurintsurg-2016-012466.

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BackgroundTo date there has been no direct comparison of two frequently used endovascular thrombectomy (EVT) methods (forced arterial suction thrombectomy (FAST) and stent retriever thrombectomy) in M2 occlusions. We review our experiences with EVT performed using FAST and stent retriever thrombectomy in such cases.MethodsThe subjects comprised 41 patients with an M2 occlusion who underwent EVT (25 with FAST, 16 with stent retriever thrombectomy). The patients' data were retrospectively analyzed to evaluate the technical characteristics and angiographic outcome of the two EVT techniques.ResultsThrombolysis In Cerebral Infarction (TICI) grades 2b–3 using the first chosen technique did not differ significantly between the two techniques (FAST 64.0% vs stent retriever thrombectomy 81.2%, p=0.305). Time from groin puncture to reperfusion was significantly shorter for stent retriever thrombectomy (53.0 vs 38.5 min; p=0.045). Distal embolization occurred in three cases (12.0%) in the FAST group and in four (26.7%) in the stent retriever group (p=0.362). However, the two techniques did not differ significantly in the final TICI 2b–3 rate (72.0% vs 87.5%; p=0.441). A frequent angiographic finding regarding the failure of FAST was that the M2 occlusion was located immediately after severe acute angulation between M1 and M2.ConclusionsStent retriever thrombectomy may provide faster reperfusion than FAST, while the FAST technique might be associated with lower distal embolization and a higher reperfusion rate for the first thrombectomy attempt, but without any significant difference in clinical outcome. When choosing the EVT method for M2 occlusions, consideration of the location of the occlusion and tortuosity between M1 and M2 might be helpful to achieve a better angiographic outcome.

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Metcalfe, Charles, Laura Chang-Kit, Ioana Dumitru, Shaun MacDonald, and Peter Black. "Antegrade balloon occlusion of inferior vena cava during thrombectomy for renal cell carcinoma." Canadian Urological Association Journal 4, no. 4 (2013): 105. http://dx.doi.org/10.5489/cuaj.892.

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Nephrectomy with inferior vena cava (IVC) thrombectomy foradvanced renal cell carcinoma (RCC) is a challenging and morbidsurgical case. We describe the use of a simple endoluminaltechnique to occlude the suprahepatic IVC during thrombectomy.A 60-year-old male presented with a large right-sided RCC andIVC tumour thrombus. The tip of the thrombus, which was nonadherentto the caval wall, extended to the level of the hepaticveins. After complete dissection of the kidney, we obtained suprahepaticcontrol of the IVC by a large compliant balloon, introducedthrough the right internal jugular vein and inflated just below thelevel of the diaphragm. The IVC thrombectomy was performedin a bloodless field. Mean blood pressure remained stable duringIVC balloon inflation with a total occlusion time of 10 minutes.Intraprocedural completion cavogram and postoperative Dopplerultrasonography showed no residual IVC clot. Blood loss duringthe thrombectomy portion of the case was scant. The patient’spostoperative course was uncomplicated and, at the last followup,he had stable metastatic disease on sunitinib therapy. For thesurgical treatment of RCC with retrohepatic IVC tumour extension,transjugular balloon occlusion of the suprahepatic IVC offers analternative to extensive hepatic mobilization to obtain suprahepaticthrombus control. Advantages over traditional surgical methodsmay include decreased surgical time, lower risk of liver injury andtumour embolism. We suggest this method for further evaluation.

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Bouslama, Mehdi, Diogo C. Haussen, Leticia C. Rebello, Jonathan A. Grossberg, Michael R. Frankel, and Raul G. Nogueira. "Repeated Mechanical Thrombectomy in Recurrent Large Vessel Occlusion Acute Ischemic Stroke." Interventional Neurology 6, no. 1-2 (2016): 1–7. http://dx.doi.org/10.1159/000447754.

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Background: Endovascular therapy has been proven effective for the treatment of large vessel occlusion strokes (LVOS). However, the feasibility and potential benefits of repeat thrombectomy for recurrent stroke is unclear. We aim to report our experience with repeat thrombectomy for recurrent LVOS. Methods: We reviewed our prospectively collected endovascular database for patients who underwent repeated mechanical thrombectomy. Baseline characteristics, procedural data and outcomes were evaluated. Patients with repeat thrombectomy were compared to patients with single thrombectomy. For patients with repeat thrombectomy, imaging and procedural variables were compared between first and last procedures. Results: Out of 697 patients treated within the study period, 15 patients (2%) had repeat thrombectomies (14 treated twice and one thrice). The mean age was 63 ± 15 years and 40% were males. The median time between the first and last procedure was 18 (1-278) days. Cardioembolism (66%) was the most common etiology, followed by intracranial atherosclerosis (13%) and large vessel atherosclerosis (6%). At 90 days after the last thrombectomy, 60% of patients achieved a modified Rankin Scale score of 0-2 and 20% were deceased. There were no statistically significant differences in demographics, stroke severity, time from last known normal to puncture, reperfusion rates, hemorrhagic complications, good clinical outcomes and mortality between patients who underwent repeat thrombectomy and those who had a single thrombectomy. Conclusion: In properly selected patients suffering recurrent LVOS, repeated mechanical thrombectomy appears to be feasible and safe. A previous thrombectomy should not discourage aggressive treatment as these patients may achieve similar rates of good clinical outcomes as those who undergo single thrombectomy.

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Tanglay, Onur, Dennis Cordato, Mark Parsons, Nathan Manning, Jason Wenderoth, and Cecilia Cappelen-Smith. "Thrombectomy averted stroke: evidence of tissue salvageability after thrombectomy." BMJ Case Reports 18, no. 4 (2025): e263961. https://doi.org/10.1136/bcr-2024-263961.

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Advances in stroke management are increasingly improving patient outcomes. We present two cases which demonstrate how endovascular thrombectomy (EVT) can alter tissue fate in ischaemic stroke. We present two cases of patients who presented with acute stroke symptoms. They both underwent imaging with CT, CT angiography and CT perfusion, which were indicative of acute ischaemic stroke. Both patients subsequently underwent EVT. On follow-up MRI within 5 days of their presentation, there were no findings indicative of ischaemic stroke. These cases of thrombectomy averted stroke are likely to become more frequent in clinical practice with advances in stroke management.

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Kamel, Hooman, Neal S. Parikh, Abhinaba Chatterjee, et al. "Access to Mechanical Thrombectomy for Ischemic Stroke in the United States." Stroke 52, no. 8 (2021): 2554–61. http://dx.doi.org/10.1161/strokeaha.120.033485.

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Background and Purpose: Mechanical thrombectomy helps prevent disability in patients with acute ischemic stroke involving occlusion of a large cerebral vessel. Thrombectomy requires procedural expertise and not all hospitals have the staff to perform this intervention. Few population-wide data exist regarding access to mechanical thrombectomy. Methods: We examined access to thrombectomy for ischemic stroke using discharge data from calendar years 2016 to 2018 from all nonfederal emergency departments and acute care hospitals across 11 US states encompassing 80 million residents. Facilities were classified as hubs if they performed mechanical thrombectomy, gateways if they transferred patients who ultimately underwent mechanical thrombectomy, and gaps otherwise. We used standard descriptive statistics and unadjusted logistic regression models in our primary analyses. Results: Among 205 681 patients with ischemic stroke, 100 139 (48.7% [95% CI, 48.5%–48.9%]) initially received care at a thrombectomy hub, 72 534 (35.3% [95% CI, 35.1%–35.5%]) at a thrombectomy gateway, and 33 008 (16.0% [95% CI, 15.9%–16.2%]) at a thrombectomy gap. Patients who initially received care at thrombectomy gateways were substantially less likely to ultimately undergo thrombectomy than patients who initially received care at thrombectomy hubs (odds ratio, 0.27 [95% CI, 0.25–0.28]). Rural patients had particularly limited access: 27.7% (95% CI, 26.9%–28.6%) of such patients initially received care at hubs versus 69.5% (95% CI, 69.1%–69.9%) of urban patients. For 93.8% (95% CI, 93.6%–94.0%) of patients with stroke at gateways, their initial facility was capable of delivering intravenous thrombolysis, compared with 76.3% (95% CI, 75.8%–76.7%) of patients at gaps. Our findings were unchanged in models adjusted for demographics and comorbidities and persisted across multiple sensitivity analyses, including analyses adjusting for estimated stroke severity. Conclusions: We found that a substantial proportion of patients with ischemic stroke across the United States lacked access to thrombectomy even after accounting for interhospital transfers. US systems of stroke care require further development to optimize thrombectomy access.

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Mannam, Sneha Sai, Alan Napole, Pierce Hunter Davis, et al. "1309 Is Medicare Valuing Strokes Less Over Time? A Look at Thrombectomy Reimbursement." Neurosurgery 71, Supplement_1 (2025): 217–18. https://doi.org/10.1227/neu.0000000000003360_1309.

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INTRODUCTION: Mechanical thrombectomy has significantly advanced acute ischemic stroke treatment, markedly improving patient outcomes. Despite its benefits, the details of Medicare’s reimbursement for this procedure remain underexplored. With Medicare expenditures rising from $670 billion in 2016 to $829 billion in 2021, it is crucial to investigate the allocation of funds to mechanical thrombectomy against the backdrop of enhanced clinical results. METHODS: This study analyzed CMS Medicare Physician & Other Practitioners Data from 2016 to 2021. We isolated mechanical thrombectomy procedures using CPT code 61645 and results were stratified by provider specialties in neurosurgery, neurology, and radiology to identify inter-specialty disparities. Inflation adjustments were applied to all monetary values. RESULTS: The analysis encompassed three specialties and 34,696 total services from 2016 to 2021. Mean reimbursement initially surged from 2016 to 2019, followed by a significant reduction from 2019 to 2021. This occurred despite procedure volume nearly tripling, from 2,483 in 2016 to 7,318 in 2021. The decline in reimbursement rates was consistent across all specialties, with 2021 figures falling below 2016 levels. This pattern highlights a discordance between the growing frequency of mechanical thrombectomy procedures and the downward trend in Medicare reimbursement over the six-year period. CONCLUSIONS: Despite mechanical thrombectomy’s efficacy in improving stroke outcomes, Medicare reimbursement rates have paradoxically decreased. This downturn is alarming given the increased adoption and expanded indications post-2016 CPT code introduction. The divergence between rising Medicare expenditures and inadequate reward for value-based care raises critical concerns about allocation priorities. This study underscores the urgent need for policy reforms to ensure that advanced, clinically successful treatments receive appropriate financial support within healthcare reimbursement systems.

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Son, Seungnam, Dae Seob Choi, Min Kyun Oh, et al. "Comparison of Solitaire thrombectomy and Penumbra suction thrombectomy in patients with acute ischemic stroke caused by basilar artery occlusion." Journal of NeuroInterventional Surgery 8, no. 1 (2014): 13–18. http://dx.doi.org/10.1136/neurintsurg-2014-011472.

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Background and purposeAcute ischemic stroke (AIS) caused by basilar artery occlusion (BAO) is a very severe neurological disease with a high mortality rate and poor clinical outcomes. In this study, we compared our experience of mechanical thrombectomy using the Solitaire stent (Solitaire thrombectomy) and manual aspiration thrombectomy using the Penumbra reperfusion catheter (Penumbra suction thrombectomy) in patients with AIS caused by BAO.Materials and methodsBetween March 2011 and December 2011, 13 patients received Solitaire thrombectomy. In January 2012, the Korean Food and Drug Administration banned the use of the Solitaire stent as a thrombectomy device, and a further 18 patients received Penumbra suction thrombectomy until December 2013. We compared parameters between patients treated with each device.ResultsSuccessful recanalization rates (Thrombolysis in Cerebral Infarction (TICI) score ≥2b: 84.6% vs 100%, p=0.168) and clinical outcomes (judged by the modified Rankin Scale scores recorded at 3 months: 3.6±2.6 vs 3.2±2.6, p=0.726) were not significantly different between the two groups. However, complete recanalization rates (TICI score of 3: 23.1% vs 72.2%, p=0.015) and total procedure times (101.9±41.4 vs 62.3±34.8 min, p=0.044) were significantly higher, and shorter, respectively, in patients treated by Penumbra suction thrombectomy.ConclusionsThe two thrombectomy devices were associated with similar recanalization rates and clinical outcomes in patients with AIS caused by BAO. However, Penumbra suction thrombectomy seemed to allow more rapid and complete recanalization than Solitaire thrombectomy.

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Sablot, Denis, Nicolas Gaillard, Philippe Smadja, Jean-Marie Bonnec, and Alain Bonafe. "Thrombectomy accessibility after transfer from a primary stroke center: Analysis of a three-year prospective registry." International Journal of Stroke 12, no. 5 (2017): 519–23. http://dx.doi.org/10.1177/1747493017701151.

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Background No comprehensive study exists about mechanical thrombectomy accessibility for patients admitted to a primary stroke center without onsite interventional neuroradiology service. Aims To evaluate mechanical thrombectomy accessibility within 6 h after transfer from a primary stroke center to a distant (156 km apart; 1.5 h by car) comprehensive stroke center. Methods Analysis of data collected in a three-year prospective registry on patients admitted to a primary stroke center within 4.5 h after symptom onset and selected for transfer to a comprehensive stroke center for mechanical thrombectomy. Eligible patients had confirmed proximal arterial occlusion and no large cerebral infarction on MRI images (DWI-ASPECTS ≥ 5). The rate of transfer, transfer without mechanical thrombectomy, mechanical thrombectomy, reperfusion (TICI score ≥ 2b-3), and the main relevant time measures were determined. Results Among the 385 patients selected for intravenous thrombolysis and/or potential mechanical thrombectomy, 211 were considered as transferrable for mechanical thrombectomy. The rate of transfer was 56.4% (n = 119/211), transfer without mechanical thrombectomy 56.3% (n = 67/119), mechanical thrombectomy 24.6% (n = 52/211), and reperfusion by MT (TICI score 2b/3) 18% (n = 38/211). The relevant median times (interquartile range) were: 130 min (62) for intravenous thrombolysis start to comprehensive stroke center door, 95 minutes (39) for primary stroke center door-out to comprehensive stroke center door-in, 191 min (44) for intravenous thrombolysis start to mechanical thrombectomy puncture, 354 min (107) for symptom onset to mechanical thrombectomy puncture and 417 min (124) for symptom onset to recanalization. Conclusions Our study suggests that transfer to a distant comprehensive stroke center is associated with reduced access to early mechanical thrombectomy in patients with acute ischemic stroke and large artery occlusion. These results could be translated to other high volume distant primary stroke center.

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22

Mathias, Klaus. "Mechanical thrombectomy for ischemic stroke: multispecialty team training in stroke mechanical thrombectomy to optimize thrombectomy deliverability." Kardiologia Polska 78, no. 7-8 (2020): 799–801. http://dx.doi.org/10.33963/kp.15566.

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Heggie, Robert, Olivia Wu, Phil White, et al. "Mechanical thrombectomy in patients with acute ischemic stroke: A cost-effectiveness and value of implementation analysis." International Journal of Stroke 15, no. 8 (2019): 881–98. http://dx.doi.org/10.1177/1747493019879656.

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Background Recent clinical trials have demonstrated the efficacy of mechanical thrombectomy in acute ischemic stroke. Aims To determine the cost-effectiveness, value of future research, and value of implementation of mechanical thrombectomy. Methods Using UK clinical and cost data from the Pragmatic Ischemic Stroke Thrombectomy Evaluation (PISTE) trial, we estimated the cost-effectiveness of mechanical thrombectomy over time horizons of 90-days and lifetime, based on a decision-analytic model, using all existing evidence. We performed a meta-analysis of seven clinical trials to estimate treatment effects. We used sensitivity analysis to address uncertainty. Value of implementation analysis was used to estimate the potential value of additional implementation activities to support routine delivery of mechanical thrombectomy. Results Over the trial period (90 days), compared with best medical care alone, mechanical thrombectomy incurred an incremental cost of £5207 and 0.025 gain in QALY (incremental cost-effectiveness ratio (ICER) £205,279), which would not be considered cost-effective. However, mechanical thrombectomy was shown to be cost-effective over a lifetime horizon, with an ICER of £3466 per QALY gained. The expected value of perfect information per patient eligible for mechanical thrombectomy in the UK is estimated at £3178. The expected value of full implementation of mechanical thrombectomy is estimated at £1.3 billion over five years. Conclusion Mechanical thrombectomy was cost-effective compared with best medical care alone over a patient’s lifetime. On the assumption of 30% implementation being achieved throughout the UK healthcare system, we estimate that the population health benefits obtained from this treatment are greater than the cost of implementation. Trial registration NCT01745692.

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Flynn, Darren, Richard Francis, Kristoffer Halvorsrud, et al. "Intra-arterial mechanical thrombectomy stent retrievers and aspiration devices in the treatment of acute ischaemic stroke: A systematic review and meta-analysis with trial sequential analysis." European Stroke Journal 2, no. 4 (2017): 308–18. http://dx.doi.org/10.1177/2396987317719362.

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Purpose Intra-arterial mechanical thrombectomy combined with appropriate patient selection (image-based selection of acute ischaemic stroke patients with large artery occlusion) yields improved clinical outcomes. We conducted a systematic review and meta-analysis, with trial sequential analysis to understand the benefits, risks and impact of new trials reporting in 2016 on the magnitude/certainty of the estimates for clinical effectiveness and safety of mechanical thrombectomy. Method Random effects’ models were conducted of randomised clinical trials comparing mechanical thrombectomy (stent retriever or aspiration devices) with/without adjuvant intravenous thrombolysis with intravenous thrombolysis and other forms of best medical/supportive care in the treatment of acute ischaemic stroke. Study inclusion and risk of bias were assessed independently by two reviewers. Functional independence (modified Rankin Scale 0–2) and mortality at 90 days, including symptomatic intracranial haemorrhage rate were extracted. Trial sequential analysis established the strength of the evidence derived from the meta-analyses. Findings Eight trials of mechanical thrombectomy with a total sample size of 1841 (916 patients treated with mechanical thrombectomy and 925 treated without mechanical thrombectomy) fulfilled review inclusion criteria. The three most recent trials more precisely defined the effectiveness of mechanical thrombectomy (modified Rankin Scale 0 to 2; OR = 2.07, 95% CI = 1.70 to 2.51 based on data from eight trials versus OR = 2.39, 95% CI = 1.88 to 3.04 based on data from five trials). Meta-analyses showed no effect on mortality (OR = 0.81, 95% CI = 0.61 to 1.07) or symptomatic intracranial haemorrhage (OR = 1.22, 95% CI = 0.80 to 1.85) as found in analysis of first five trials. Trial sequential analysis indicated that the information size requirement was fulfilled to conclude the evidence for mechanical thrombectomy is robust. Discussion The impact of three recent trials on effectiveness and safety of mechanical thrombectomy was a more precise pooled effect size for functional independence. Trial sequential analysis demonstrated sufficient evidence for effectiveness and safety of mechanical thrombectomy. Conclusion No further trials of mechanical thrombectomy versus no mechanical thrombectomy are indicated to establish clinical effectiveness. Uncertainty remains as to whether mechanical thrombectomy reduces mortality or increases risk of symptomatic intracranial haemorrhage.

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Lavie, Jayson, Ananth K. Vellimana, and Arindam Rano Chatterjee. "Endovascular Thrombectomy Treatment." Topics in Magnetic Resonance Imaging 30, no. 4 (2021): 173–80. http://dx.doi.org/10.1097/rmr.0000000000000291.

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Lobotesis, Kyriakos, and Brian H. Buck. "Direct to Thrombectomy." Stroke 52, no. 7 (2021): 2442–44. http://dx.doi.org/10.1161/strokeaha.121.034423.

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Hastaoğlu, İsmail Oral. "Catheter-assisted thrombectomy." Turkish Journal of Thoracic and Cardiovascular Surgery 22, no. 3 (2014): 656–60. http://dx.doi.org/10.5606/tgkdc.dergisi.2014.9290.

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Jankowitz, Brian, Amin Aghaebrahim, Alexandra Zirra, et al. "Manual Aspiration Thrombectomy." Stroke 43, no. 5 (2012): 1408–11. http://dx.doi.org/10.1161/strokeaha.111.646117.

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Hummel, T., S. Reich-Schupke, A. Mumme, D. Mühlberger, and E. M. Wolff. "Multimodal venous thrombectomy." Phlebologie 46, no. 02 (2017): 106–8. http://dx.doi.org/10.12687/phleb2352-2-2017.

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Gill, Dipender, Rhannon Lobo, Prasanthi Sivakumaran, and Arindam Kar. "Expected thrombectomy caseload." International Journal of Stroke 11, no. 7 (2016): NP76. http://dx.doi.org/10.1177/1747493016641115.

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May, Maeva. "Thrombectomy in UK." British Journal of Neuroscience Nursing 20, Sup5 (2024): S255—S257. http://dx.doi.org/10.12968/bjnn.2024.0063.

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Juhan, C., Y. Alimi, P. Di Mauro, and O. Hartung. "Surgical Venous Thrombectomy." Cardiovascular Surgery 7, no. 6 (1999): 586–90. http://dx.doi.org/10.1177/096721099900700603.

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Rehabilitation of the technique of venous thrombectomy is justified, but, in order for this technique to be effective, it must only be performed in selected cases. In the authors' view it is of the utmost value in young patients when the venous thrombosis occurs accidentally, after traumatism or surgery and when a diagnostic is made without delay.

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Lang, Elvira V., William H. Barnhart, Dale L. Walton, and Stephen S. Raab. "Percutaneous Pulmonary Thrombectomy." Journal of Vascular and Interventional Radiology 8, no. 3 (1997): 427–32. http://dx.doi.org/10.1016/s1051-0443(97)70583-9.

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Diament, R. H. "CHEST DRAIN THROMBECTOMY." Lancet 333, no. 8646 (1989): 1074. http://dx.doi.org/10.1016/s0140-6736(89)92467-7.

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Sabaté, Manel, and Salvatore Brugaletta. "Thrombectomy and Stroke." Journal of the American College of Cardiology 72, no. 14 (2018): 1597–99. http://dx.doi.org/10.1016/j.jacc.2018.07.048.

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Juhan, C. "Surgical venous thrombectomy." Cardiovascular Surgery 7, no. 6 (1999): 586–90. http://dx.doi.org/10.1016/s0967-2109(99)00052-6.

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Chant, H., R. Ashleigh, and C. McCollum. "Thrombectomy for Acute Internal Carotid Thrombosis: Five Thrombectomy Devices Compared." European Journal of Vascular and Endovascular Surgery 27, no. 4 (2004): 403–8. http://dx.doi.org/10.1016/j.ejvs.2003.12.014.

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Abilleira, Sònia, Cristian Tebé, Natalia Pérez de la Ossa, et al. "Geographic dissemination of endovascular stroke thrombectomy in Catalonia within the 2011–2015 period." European Stroke Journal 2, no. 2 (2017): 163–70. http://dx.doi.org/10.1177/2396987317696376.

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Introduction Endovascular thrombectomy was recently established as a new standard of care in acute ischemic stroke patients with large artery occlusions. Using small area health statistics, we sought to assess dissemination of endovascular thrombectomy in Catalonia throughout the period 2011–2015. Patients and methods We used registry data to identify all endovascular thrombectomies for acute ischemic stroke performed in Catalonia within the study period. The SONIIA registry is a government-mandated, population-based and externally audited data base that includes all reperfusion therapies for acute ischemic stroke. We linked endovascular thrombectomy cases identified in the registry with the Central Registry of the Catalan Public Health Insurance to obtain the primary care service area of residence for each treated patient, age and sex. We calculated age-sex standardized endovascular thrombectomy rates over time according to different territorial segmentation patterns (metropolitan/provincial rings and primary care service areas). Results Region-wide age-sex standardized endovascular thrombectomy rates increased significantly from 3.9 × 100,000 (95% confidence interval: 3.4–4.4) in 2011 to 6.8 × 100,000 (95% confidence interval: 6.2–7.6) in 2015. Such increase occurred in inner and outer metropolitan rings as well as provinces although highest endovascular thrombectomy rates were persistently seen in the inner metropolitan area. Changes in endovascular thrombectomy access across primary care service areas over time were more subtle, but there was a rather generalized increase of standardized endovascular thrombectomy rates. Discussion This study demonstrates temporal and territorial dissemination of access to endovascular thrombectomy in Catalonia over a 5-year period although variation remains at the completion of the study. Conclusion Mapping of endovascular thrombectomy is essential to assess equity and propose actions for access dissemination.

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Ronadi, Daniel, and I. Made Arya Winatha. "037. Outcomes of Management of Adult Patients with Acute Limb Ischemia Using Catheter-Directed Thrombolysis (CDT) and Thrombectomy: A Systematic Review." JBN (Jurnal Bedah Nasional) 8, no. 2 (2024): 37. http://dx.doi.org/10.24843/jbn.2024.v08.is02.p037.

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Background: Acute limb ischemia (ALI) is one of the arterial emergencies of sudden decrease in limb perfusion and poses a threat to limb viability. Immediate management is required for better prognosis of the patient. Treatment with Catheter-directed thrombolysis (CDT) and thrombectomy methods have their own advantages and disadvantages that require further study. Methods: The authors completed a descriptive systematic review of retrospective cohort studies and randomised controlled trials (RCTs) based on PRISMA guidelines, including studies that included CDT and thrombectomy interventions in patients with acute limb ischemia. Data were extracted on sample size, age, diagnosis, mechanism of intervention, treatment outcome and complications. Results: Of the 304 studies, the authors included 5 cohort studies and RCTs, with a total sample size of 5,781 samples aged 60-72 years. All studies used CDT method, compared with various thrombectomy (Percutaneous aspiration thrombectomy (PAT), Pharmacomechanical thrombectomy (PMT), Percutaneous mechanical thrombectomy (PMT), Catheter-based thrombectomy (CBT), and Operative embolectomy. It was found that therapeutic outcomes based on risk of amputation, mortality and complications did not show significant differences between the two groups, but hospitalisation duration outcomes appeared longer in patients with CDT than thrombectomy (p value 0.0001 and 0.000). Conclusion: ALI is a condition that requires immediate management to reopen arterial flow so that ischaemic conditions in the tissue can be avoided, various intervention methods either with medication (thrombolysis) or invasive procedures with thrombectomy are considered to provide good outcomes in patients.

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Li, Guangshuo, Rui Huang, Weishuai Li, Xiaotian Zhang, and Guorong Bi. "Mechanical thrombectomy with second-generation devices for acute cerebral middle artery M2 segment occlusion: A meta-analysis." Interventional Neuroradiology 26, no. 2 (2019): 187–94. http://dx.doi.org/10.1177/1591019919886405.

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Background The benefit of mechanical thrombectomy for an acute ischemic stroke involving M2 segment occlusion is not clear, especially when performed with second-generation thrombectomy devices. Method We reviewed the literature to investigate clinical outcomes and the rates of recanalization, symptomatic intracerebral hematoma, and mortality in mechanical thrombectomy performed using second-generation thrombectomy devices. We compared the outcomes between patients treated for M2 and M1 occlusions. Results Seven studies involving 805 patients with M2 thrombectomy were included in this meta-analysis. The functional independence rate 90 days after thrombectomy (modified Rankin Scale 0–2) was 59.3% (OR 1.81, 95% CI 1.74–1.88). The recanalization rate (thrombolysis in cerebral infarction 0–2) was 84.16% (OR 2.32, 95% CI 2.08–2.29). The symptomatic intracerebral hematoma rate was 4.9% (OR 1.05, 95% CI 1.03–1.09). The mortality was 7.7% (OR 1.08, 95% CI 1.03–1.13). The outcomes were better in patients with M2 occlusion than in those with M1 occlusion. In a subgroup analysis, we found that among patients with hypertension, mechanical thrombectomy achieved better functional outcomes and recanalization in M2 occlusion than M1 occlusion. Conclusion Mechanical thrombectomy performed with second-generation thrombectomy devices for M2 occlusion can provide a good functional outcome as well as satisfying recanalization. Moreover, there was no significant difference in the symptomatic intracerebral hematoma and mortality rates, suggesting this procedure is as safe in M2 occlusion as in M1 occlusion.

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Aydın, Ebuzer. "Comparison of pharmacomechanical and surgical interventions for thrombosed native arteriovenous fistulas." Turkish Journal of Thoracic and Cardiovascular Surgery 28, no. 4 (2020): 609–14. http://dx.doi.org/10.5606/tgkdc.dergisi.2020.19565.

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Background: This study aims to compare success and patency rates of pharmacomechanical thrombectomy versus open surgical thrombectomy for thrombosed native arteriovenous fistulas. Methods: A total of 96 patients (56 males, 40 females; mean age 61±11.7 years; range, 26 to 82 years) with a thrombosed native arteriovenous fistula between January 2016 and December 2018 were retrospectively analyzed. The patients were divided into two groups as pharmacomechanical thrombectomy (n=42) and open surgical thrombectomy (n=54). Primary failure rate and primary patency rate at 6 and 12 months were recorded. Results: Of 42 patients in the pharmacomechanical thrombectomy group, 41 (98%) had additional interventions, and primary failure occurred in four patients (10%). Primary failure was seen in 15 (28%) patients in the surgical group. The primary patency rates at 6 and 12 months were significantly higher in the pharmacomechanical treatment group than the surgical group (85% vs. 67% and 78% vs. 55%, respectively; p<0.05). Conclusion: Pharmacomechanical thrombectomy procedure yields higher primary patency rates than open surgical thrombectomy for thrombosed native arteriovenous fistula.

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Kwak, Hyo S., and Jung S. Park. "Successful recanalization using the Embolus Retriever with Interlinked Cage for acute stroke due to calcified cerebral emboli." Interventional Neuroradiology 24, no. 6 (2018): 674–77. http://dx.doi.org/10.1177/1591019918784259.

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Mechanical thrombectomy is a safe and effective treatment in patients with acute ischemic stroke caused by large vessel occlusions. However, in rare cases, the procedure may be challenging due to the composition of the embolus. We describe a case of a mechanical thrombectomy with the Embolus Retriever with Interlinked Cage (ERIC) device in a patient with an acute ischemic stroke due to calcified cerebral emboli in the middle cerebral artery. The procedure was done after a failed recanalization attempt with manual aspiration thrombectomy. An 82-year-old woman presented to the emergency department with a sudden onset of right-sided weakness. A computed tomographic angiography showed left middle cerebral (M1 branch) calcified emboli. After the administration of an intravenous thrombolytic agent, the patient was transferred to the angiographic suite for a mechanical thrombectomy. After failure to recanalize the vessel with manual aspiration thrombectomy, successful recanalization was achieved via mechanical thrombectomy using the ERIC device. Mechanical thrombectomy with an ERIC device can be a useful option in cases of acute ischemic stroke caused by calcified cerebral emboli.

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Wolman, Dylan N., David G. Marcellus, Maarten G. Lansberg, et al. "Endovascular versus medical therapy for large-vessel anterior occlusive stroke presenting with mild symptoms." International Journal of Stroke 15, no. 3 (2019): 324–31. http://dx.doi.org/10.1177/1747493019873510.

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Background Acute ischemic stroke patients with a large-vessel occlusion but mild symptoms (NIHSS ≤ 6) pose a treatment dilemma between medical management and endovascular thrombectomy. Aims To evaluate the differences in clinical outcomes of endovascular thrombectomy-eligible patients with target-mismatch perfusion profiles who undergo either medical management or endovascular thrombectomy. Methods Forty-seven patients with acute ischemic stroke due to large-vessel occlusion, NIHSS ≤ 6, and a target-mismatch perfusion imaging profile were included. Patients underwent medical management or endovascular thrombectomy following treating neurointerventionalist and neurologist consensus. The primary outcome measure was NIHSS shift. Secondary outcome measures were symptomatic intracranial hemorrhage, in-hospital mortality, and 90-day mRS scores. The primary intention-to-treat and as-treated analyses were compared to determine the impact of crossover patient allocation on study outcome measures. Results Forty-seven patients were included. Thirty underwent medical management (64%) and 17 underwent endovascular thrombectomy (36%). Three medical management patients underwent endovascular thrombectomy due to early clinical deterioration. Presentation NIHSS ( P = 0.82), NIHSS shift ( P = 0.62), and 90-day functional independence (mRS 0–2; P = 0.25) were similar between groups. Endovascular thrombectomy patients demonstrated an increased overall rate of intracranial hemorrhage (35.3% vs. 10.0%; P = 0.04), but symptomatic intracranial hemorrhage was similar between groups ( P = 0.25). In-hospital mortality was similar between groups ( P = 0.46), though all two deaths in the medical management group occurred among crossover patients. Endovascular thrombectomy patients demonstrated a longer length of stay (7.6 ± 7.2 vs. 4.3 ± 3.9 days; P = 0.04) and a higher frequency of unfavorable discharge to a skilled-nursing facility ( P = 0.03) rather than home ( P = 0.05). Conclusions Endovascular thrombectomy may pose an unfavorable risk-benefit profile over medical management for endovascular thrombectomy-eligible acute ischemic stroke patients with mild symptoms, which warrants a randomized trial in this subpopulation.

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Aytaç, Emrah, Ferhat Balgetir, Şule Kavak Genç, Murat Gönen, Hasan Dogan, and Cetin Kursad Akpinar. "Effect of inflammatory response before mechanical thrombectomy on prognosis in stroke patients." Ideggyógyászati szemle 77, no. 9-10 (2024): 323–27. http://dx.doi.org/10.18071/isz.77.0323.

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Background and purpose – Mechanical thrombectomy is the most important treatment modality in acute stroke; despite successful thrombectomy, good functional outcome is not achieved in a significant proportion of patients. This study examined the effect of neutrophil lymphocyte ratio (NLR) values at admission on functional outcomes in successfully recanalized patients. Methods – Patients who underwent mechanical thrombectomy due to anterior system major vessel occlusion were retrospectively analyzed and compared with the admission NLR values and 3-month clinical modified Rankin Scale (mRS) scores of successfully recanalized patients. Results – Of a total of 126 patients who underwent thrombectomy within the specified period, 97 patients with successful recanalization were included in the study. The overall successful recanalization rate was calculated as 77%. The mean NLR of patients with mRS ≤2 (n=65) was found to be significantly lower than patients with mRS≥3 (n=32) (p<0.001). A weak and significant correlation was found between National Institutes of Health Stroke Scale (NIHSS) value and NLR (r= 0.315, p=.002). Conclusion – NLR value has been found to be associated with futile recanalization in mechanical thrombectomy patients. Therefore, we think that suppression of inflammation before thrombectomy will increase the chance of successful thrombectomy.

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Zhou, Bing, Xiao-Chuan Wang, Jun-Yi Xiang, et al. "Mechanical thrombectomy using a Solitaire stent retriever in the treatment of pediatric acute ischemic stroke." Journal of Neurosurgery: Pediatrics 23, no. 3 (2019): 363–68. http://dx.doi.org/10.3171/2018.9.peds18242.

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OBJECTIVEMechanical thrombectomy using a Solitaire stent retriever has been widely applied as a safe and effective method in adult acute ischemic stroke (AIS). However, due to the lack of data, the safety and effectiveness of mechanical thrombectomy using a Solitaire stent in pediatric AIS has not yet been verified. The purpose of this study was to explore the safety and effectiveness of mechanical thrombectomy using a Solitaire stent retriever for pediatric AIS.METHODSBetween January 2012 and December 2017, 7 cases of pediatric AIS were treated via mechanical thrombectomy using a Solitaire stent retriever. The clinical practice, imaging, and follow-up results were reviewed, and the data were summarized and analyzed.RESULTSThe ages of the 7 patients ranged from 7 to 14 years with an average age of 11.1 years. The preoperative National Institutes of Health Stroke Scale (NIHSS) scores ranged from 9 to 22 with an average of 15.4 points. A Solitaire stent retriever was used in all patients, averaging 1.7 applications of thrombectomy and combined balloon dilation in 2 cases. Grade 3 on the modified Thrombolysis In Cerebral Infarction scale of recanalization was achieved in 5 cases and grade 2b in 2 cases. Six patients improved and 1 patient died after thrombectomy. The average NIHSS score of the 6 cases was 3.67 at discharge. The average modified Rankin Scale score was 1 at the 3-month follow-up. Subarachnoid hemorrhage after thrombectomy occurred in 1 case and that patient died 3 days postoperatively.CONCLUSIONSThis study shows that mechanical thrombectomy using a Solitaire stent retriever has a high recanalization rate and excellent clinical prognosis in pediatric AIS. The safety of mechanical thrombectomy in pediatric AIS requires more clinical trials for confirmation.

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Alawieh, Ali, Jan Vargas, Raymond D. Turner, et al. "Equivalent favorable outcomes possible after thrombectomy for posterior circulation large vessel occlusion compared with the anterior circulation: the MUSC experience." Journal of NeuroInterventional Surgery 10, no. 8 (2017): 735–40. http://dx.doi.org/10.1136/neurintsurg-2017-013420.

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IntroductionIn acute ischemic stroke (AIS), posterior circulation large vessel occlusions (LVOs) have been associated with poorer outcomes compared with anterior circulation LVOs. The outcomes of anterior versus posterior circulation thrombectomy for LVOs were compared at a high volume center employing a direct aspiration first pass technique (ADAPT).MethodsWe retrospectively studied a database of AIS cases that underwent ADAPT thrombectomy for LVOs. Cases were grouped by anatomical location of thrombectomy (posterior vs anterior circulation), and analysis was performed on both entire sample size.ResultsA total of 436 AIS patients (50.2% women, mean age 67.3 years) underwent ADAPT thrombectomy for LVO during the study period, of whom 13% of had posterior circulation thrombectomy. Patients with posterior circulation thrombectomy did not show a significant difference in preprocedural variables, including age, baseline National Institutes of Health Stroke Scale (NIHSS), and onset to groin time, compared with anterior circulation (P>0.05). There were also no differences in procedural variables between the two groups. Patients in the posterior group were found to have a similar likelihood of good outcome (modified Rankin Scale score 0—2) at 90 days compared with the anterior group (42.9% vs 43.2%, respectively), and a small but not significant increase in mortality at 90 days. Multilogistic regression analysis showed that the anatomical location (anterior vs posterior) was not an independent predictor of good outcome or mortality after thrombectomy. Prominent predictors of outcome/mortality included age, female gender, procedure time, and baseline NIHSS.ConclusionsOur findings demonstrate that when patients are carefully selected for thrombectomy, those with posterior circulation LVOs can achieve similar outcomes compared with anterior circulation thrombectomy, indicating comparable safety and efficacy profiles.

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Casetta, Ilaria, Giovanni Pracucci, Andrea Saletti, et al. "Combined intravenous and endovascular treatment versus primary mechanical thrombectomy. The Italian Registry of Endovascular Treatment in Acute Stroke." International Journal of Stroke 14, no. 9 (2019): 898–907. http://dx.doi.org/10.1177/1747493019851279.

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Background Whether mechanical thrombectomy alone may achieve better or at least equal clinical outcome than mechanical thrombectomy combined with intravenous thrombolysis is a matter of debate. Methods From the Italian Registry of Endovascular Stroke Treatment, we extracted all cases treated with intravenous thrombolysis followed by mechanical thrombectomy or with primary mechanical thrombectomy for anterior circulation stroke due to proximal vessel occlusion. We included only patients who would have qualified for intravenous thrombolysis. We compared outcomes of the two groups by using multivariate regression analysis and propensity score method. Results We included 1148 patients, treated with combined intravenous thrombolysis and mechanical thrombectomy therapy (n = 635; 55.3%), or with mechanical thrombectomy alone (n = 513; 44.7%). Demographic and baseline clinical characteristics did not differ between the two groups, except for a shorter onset to groin puncture time (p < 0.05) in the mechanical thrombectomy group. A shift in the 90-day modified Rankin Scale distributions toward a better outcome was found in favor of the combined treatment (adjusted common odds ratio = 1.3; 95% confidence interval: 1.04–1.66). Multivariate analyses on binary outcome show that subjects who underwent combined treatment had higher probability to survive with modified Rankin Scale 0–3 (odds ratio = 1.42; 95% confidence interval: 1.04–1.95) and lower case fatality rate (odds ratio = 0.6; 95% confidence interval: 0.44–0.9). Hemorrhagic transformation did not differ between the two groups. Conclusion These data seem to indicate that combined intravenous thrombolysis and mechanical thrombectomy could be associated with lower probability of death or severe dependency after three months from stroke due to large vessel occlusion, supporting the current guidelines of treating eligible patients with intravenous thrombolysis before mechanical thrombectomy.

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Tsang, Anderson Chun On, I.-Hsiao Yang, Emanuele Orru, et al. "Overview of endovascular thrombectomy accessibility gap for acute ischemic stroke in Asia: A multi-national survey." International Journal of Stroke 15, no. 5 (2019): 516–20. http://dx.doi.org/10.1177/1747493019881345.

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Endovascular thrombectomy revolutionized the treatment of acute ischemic stroke. Nevertheless, access to endovascular thrombectomy is limited in many parts of the world. Asia holds 60% of the world’s population and its countries carry some of the highest stroke disease burden. To understand the availability of endovascular thrombectomy and intravenous thrombolysis in this region, we interviewed stroke neurologists and neuro-interventionists of 19 Asian countries, and found a large disparity in access to endovascular thrombectomy and intravenous thrombolysis between high- and low-income countries. Lack of neuro-interventionists, comprehensive stroke units, stroke triage systems and high treatment cost are the major obstacles to wider accessibility of endovascular thrombectomy, especially among developing countries. The potential solutions to provide equitable access to stroke revascularization therapy are discussed.

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Jabbour, Richard J., Helen Routledge, and Nick Curzen. "How do we ensure that more patients receive stroke thrombectomy in the UK?" British Journal of Hospital Medicine 84, no. 5 (2023): 1–4. http://dx.doi.org/10.12968/hmed.2023.0111.

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Stroke is a major cause of death in the UK. Mechanical thrombectomy is the most effective treatment for large vessel ischaemic strokes. Despite this, very few patients in the UK receive mechanical thrombectomy. This editorial explores the main barriers to mechanical thrombectomy use and mechanisms to improve uptake.

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Aydin, Kubilay, Mehmet Barburoglu, Ozgur Oztop Cakmak, Nilufer Yesilot, Ebru Nur Yavuz Vanli, and Sergin Akpek. "Crossing Y-Solitaire thrombectomy as a rescue treatment for refractory acute occlusions of the middle cerebral artery." Journal of NeuroInterventional Surgery 11, no. 3 (2018): 246–50. http://dx.doi.org/10.1136/neurintsurg-2018-014288.

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BackgroundMechanical thrombectomy using a stent retriever has become the standard of care for acute large-vessel occlusions in the anterior circulation. Clots that are refractory to single stent retriever thrombectomy remain a challenge for neurointerventionalists.ObjectiveTo assess the efficacy and safety of double stent retriever (crossing Y-Solitaire) thrombectomy as a rescue treatment for acute middle cerebral artery (MCA) occlusions that are refractory to single stent retriever thrombectomy.MethodsWe retrospectively reviewed the databases of our hospitals to identify patients who presented with an acute MCA occlusion and were treated with crossing Y-Solitaire thrombectomy. The angiographic (Thrombolysis in Cerebral Infarction (TICI) scale) and clinical outcomes (National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) scores) and complications were assessed.ResultsTen patients were included in the study. The median initial NIHSS score and Alberta Stroke Program Early CT Score (ASPECTS) were 19.0 and 9.6, respectively. Crossing Y-Solitaire thrombectomy was performed as a rescue technique after unsuccessful single Solitaire thrombectomy passes in all cases. Successful recanalization (TICI 2b/3) was achieved in 8 (80%) patients. We observed asymptomatic reperfusion hemorrhages in 2 (20%) patients. No procedural related complications were seen other than reversible vasospasms in 5 (50%) patients. Sixty percent of the patients had a mRS score of between 2 and 0 at 90 days after the procedure. There was no mortality.ConclusionCrossing Y-Solitaire thrombectomy seems to be an effective and safe alternative rescue technique to treat refractory MCA bifurcation occlusions that are refractory to standard thrombectomy procedures.

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