Manual aspiration thrombectomy using the Penumbra catheter in patients with acute M1 occlusion: A single-center study.

Kim, Yong Seek; Kwak, Hyo Sung; Chung, Gyung Ho; Hwang, Seung Bae

PURPOSE The efficacy and safety of aspiration thrombectomy using Penumbra in acute occlusion of intracranial artery have been proved in many previous studies. Our study aimed to retrospectively assess the efficacy and safety of a manual aspiration thrombectomy using Penumbra in patients with M1 occlusion. MATERIALS AND METHODS We conducted a retrospective review of 70 patients who underwent manual aspiration thrombectomy using Penumbra catheters for treatment of M1 occlusion between January 2012 and December 2014. We evaluated immediate angiographic results and clinical outcomes through review of patient electronic medical records. RESULTS Male was the dominant sex in this study (M:F = 38:32) and median age was 72 (age range, 36-91). The rate of successful recanalization (TICI grade ≥2 b) was 91.4% (64/70). The successful recanalization rate by single Penumbra was 82.9% (58/70). Six patients were treated in combination with Solitaire stent. Median NIHSS score was 11 (range, 4-20) at admission and was 3 (range 0-23) at discharge. Favorable clinical outcomes (mRS score at three months ≤2) were seen in 42 patients (60%). Two patients were observed to have subarachnoid hemorrhage after the procedure. Another two patients died related to massive symptomatic hemorrhage, brain edema and herniation in the hospital. CONCLUSION Manual aspiration thrombectomy appears to be safe and is capable of achieving a high rate of successful recanalization and favorable clinical outcomes in patients with M1 occlusion.