Mechanical thrombectomy in severe acute stroke: preliminary results of the Solitaire stent

Intravenous recombinant tissue plasminogen activator (rTPA) therapy has limited recanalisation-rates in large artery occlusions (nadir of 5.9% in Carotid-T-Occlusions).1 Therefore, we prospectively evaluated the Solitaire stent (versions AB and FR, ev3 Inc., Plymouth, Minnesota, USA) in mechanical thrombectomy in acute ischaemic stroke. Acute stroke patients were triaged on admission for potential mechanical thrombectomy. ### Inclusion criteria ### Exclusion criteria Eligible patients had immediate CT-angiography without delaying intravenous rTPA-thrombolysis if applicable according to the guidelines of the German Neurological Society (DGN). In case of occlusion of either the internal carotid artery (ICA), the MCA-M1-segment or the basilar artery (BA) mechanical thrombectomy was carried out. Up to four clot extraction maneuvers were performed. Any preceding stenosis was a priori stented. These patients received intravenous eptifibatide for 24 h to prevent in-stent-thrombosis; its short half-life would allow for emergency decompressive craniectomy. Combination of rTPA and eptifibatide is safe.2 NIHSS and mRS scores were assessed on admission and …