Objective

The aim of this study was to evaluate the safety and efficacy of a manually expandable stent retriever (Tigertriever, Rapid Medical, Yoqneam, Israel) in the treatment of acute ischemic stroke caused by intracranial large vessel occlusions (LVO).

Methods

We performed a single center retrospective analysis of all patients treated by mechanical thrombectomy due to LVO using the Tigertriever. The angiographic and clinical success was evaluated by the modified thrombolysis in cerebral infarction score (mTICI) and the modified Rankin score (mRS).

Results

A total of 68 acute intracranial arterial occlusions in 61 patients (42 female, median age 77 years, range 43–92 years) were treated by mechanical thrombectomy using the Tigertriever. The overall successful reperfusion rate (mTICI 2b-3) was 85.3% (58/68 occlusions) with a first pass effect (mTICI 3) of 23.5% (16/68 occlusions). In 57 of the 68 occlusions the Tigertriever was used on an intention to treat approach with a success rate of 86.0% and in the 11 remaining occlusions where the Tigertriever was used as a bail-out device the success rate was 81.9%. In seven patients a mild subarachnoid hemorrhage occurred (11.5%) and one symptomatic intracerebral hemorrhage was observed (1.6%). At discharge 39.3% of the patients (24/61) had a favorable outcome (mRS 0–2).

Conclusion

The Tigertriever offers a safe and effective treatment option in ischemic stroke due to LVOs with reperfusion rates and a safety profile similar to alternative devices. The Tigertriever is a promising bail-out tool in complex cases. Its role as a first line device has to be evaluated in further prospective studies.

中文翻译：

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使用手动可扩张支架取出器 (Tigertriever) 进行急性缺血性卒中的机械取栓术：初步单中​​心经验。

客观的

本研究的目的是评估手动扩张支架取栓器（Tigertriever，Rapid Medical，Yoqneam，Israel）在治疗由颅内大血管闭塞（LVO）引起的急性缺血性卒中的安全性和有效性。

方法

我们使用 Tigertriever 对因 LVO 接受机械取栓治疗的所有患者进行了单中心回顾性分析。通过改良的脑梗死溶栓评分 (mTICI) 和改良的 Rankin 评分 (mRS) 评估血管造影和临床成功。

结果

使用 Tigertriever 通过机械取栓治疗 61 名患者（42 名女性，中位年龄 77 岁，范围 43-92 岁）中的 68 处急性颅内动脉闭塞。总体成功再灌注率 (mTICI 2b-3) 为 85.3%（58/68 次闭塞），首过效应（mTICI 3）为 23.5%（16/68 次闭塞）。在 68 次咬合中，有 57 次使用 Tigertriever 进行意向治疗，成功率为 86.0%，在剩余的 11 次使用 Tigertriever 作为救助装置的咬合中，成功率为 81.9%。7 名患者出现轻度蛛网膜下腔出血 (11.5%)，并观察到 ​​1 名有症状的脑内出血 (1.6%)。出院时 39.3% (24/61) 的患者结果良好 (mRS 0-2)。

结论

Tigertriever 为因 LVO 引起的缺血性中风提供了一种安全有效的治疗选择，其再灌注率和安全性类似于替代设备。Tigertriever 是一种在复杂情况下很有前途的救助工具。它作为一线设备的作用必须在进一步的前瞻性研究中进行评估。