Temporary endovascular bypass: rescue technique during mechanical thrombolysis.

Journal Article

BACKGROUND: The goal of mechanical thrombolysis is to re-establish blood flow to a completely occluded artery in patients who fail intravenous thrombolytic therapy or who are outside the therapeutic window. OBJECTIVE: We present our single-institution experience with the use of temporary, partial deployment of a self-expanding intracranial stent as a rescue technique for the treatment of acute stroke. The use of the Enterprise stent represents an off-label use of a humanitarian device exemption device. METHODS: We performed a retrospective review of a prospective database of acute stroke patients treated with intra-arterial techniques at the Thomas Jefferson University Comprehensive Stroke Center from July 2009 to July 2010. RESULTS: Seven patients were included, and we obtained a 100% recanalization rate to Thrombolysis in Myocardial Infarction grade 2 and 3 with a 28% asymptomatic hemorrhagic transformation. No device-related complications were encountered. CONCLUSION: Temporary, partial deployment of a self-expanding intracranial stent as a rescue procedure is feasible, effective, and safe in the setting of endovascular intervention for acute stroke, although our experience is limited. This technique was used only as a rescue procedure when more established procedures failed.

Full Text

Duke Authors

Cited Authors

  • Gonzalez, LF; Jabbour, P; Tjoumakaris, S; Teufack, S; Gordon, D; Dumont, A; Rosenwasser, R

Published Date

  • January 2012

Published In

Volume / Issue

  • 70 / 1

Start / End Page

  • 245 - 252

PubMed ID

  • 21788918

Electronic International Standard Serial Number (EISSN)

  • 1524-4040

International Standard Serial Number (ISSN)

  • 0148-396X

Digital Object Identifier (DOI)

  • 10.1227/neu.0b013e31822e5a62

Language

  • eng