Endovascular mechanical recanalisation of acute carotid-T occlusions: a single-center retrospective analysis.

PURPOSE: Acute carotid-T occlusion generally responds poorly to thrombolysis. Endovascular mechanical thrombectomy (EMT) seems to be a promising alternative. However, there are few data on EMT in carotid-T occlusions.

MATERIALS AND

METHODS

We reviewed data of 14 consecutive patients with acute carotid-T occlusions treated with mechanical recanalisation devices. A clot separation/aspiration system was used in 11 patients; different other mechanical retriever devices were used in seven patients; and stents were used in four patients. Modified Rankin Scale scores at 90 days were recorded to assess functional outcome.

RESULTS

Six women and eight men were included in the study. Mean patient age was 59.2 years; median National Institute of Health Stroke Scale score on admission was 19; and mean time to treatment was 4.2 h. Successful recanalisation (Thrombolysis in Myocardial Infarction [TIMI] score II and III) was achieved in 11 patients (78.6%). Seven patients (50.0%) were treated with more than one device, leading to successful recanalisation in six of these patients (85.7%). Subarachnoid haemorrhage and large space-occupying bleedings occurred in one (7.1%) and three (21.4%) patients, respectively. At follow-up, three patients (21.4%) were functionally independent, and six (42.9%) had died.

CONCLUSION

When applying different mechanical devices, we found a high recanalisation rate. However, discrepancy between recanalisation and clinical outcome remained. More data are needed to assess the effect of the different methods on the prognoses of stroke patients.