Purpose

To evaluate the safety and efficacy of the Tigertriever 13 (Rapid Medical, Yoqneam, Israel) stent retriever in acute ischemic stroke (AIS) patients with primary or secondary distal, medium vessel occlusions (DMVO).

Methods

We performed a retrospective analysis of all consecutive AIS patients who underwent thrombectomy with the Tigertriever13 for DMVO. Patients’ characteristics were reviewed, procedural complications, angiographic (modified thrombolysis in cerebral infarction score [mTICI]) and clinical (modified Rankin Scale [mRS]) outcomes were documented.

Results

Between November 2019 and November 2020, 16 patients with 17 DMVO were included (40% female, median age 60 [50–65] years). The Tigertriever13 was used in 11/17 (65%, median NIHSS of 8 [6–15]) primary DMVO and in 6/17 (35%, median NIHSS of 20 [13–24]) cases of secondary DMVO after a proximal thrombectomy. The successful reperfusion rate (mTICI 2b, 2c, 3) was 94% (16/17) for the dedicated vessel. At day 1, CT imaging showed a subarachnoid hemorrhage in 29% of the cases and a parenchymal hematoma in 12%. At 3 months, 65% of the patients (11/17) had a favorable outcome (mRS 0–2).

Conclusion

Mechanical thrombectomy using the Tigertriever13 appears to be safe and effective for DMVO. Clinical and anatomical results are in line with those of patients with proximal occlusions.

中文翻译：

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新一代 Stentretriever (Tigertriever 13) 用于远端中型血管闭塞的血栓切除术

目的

评估 Tigertriever 13 (Rapid Medical, Yoqneam, Israel) 支架取栓器在原发性或继发性远端中度血管闭塞 (DMVO) 急性缺血性卒中 (AIS) 患者中的安全性和有效性。

方法

我们对所有连续使用 Tigertriever13 进行 DMVO 血栓切除术的 AIS 患者进行了回顾性分析。回顾了患者的特征，记录了手术并发症、血管造影（改良的脑梗死溶栓评分 [mTICI]）和临床（改良的 Rankin 量表 [mRS]）结果。

结果

在 2019 年 11 月至 2020 年 11 月期间，纳入了 16 名患有 17 次 DMVO 的患者（40% 为女性，中位年龄为 60 [50-65] 岁）。Tigertriever13 用于 11/17（65%，中位 NIHSS 为 8 [6-15]）原发性 DMVO 和 6/17（35%，中位 NIHSS 为 20 [13-24]）继发性 DMVO 后近端血栓切除术。专用血管的成功再灌注率 (mTICI 2b, 2c, 3) 为 94% (16/17)。第 1 天，CT 成像显示 29% 的病例出现蛛网膜下腔出血，12% 的病例出现实质血肿。在 3 个月时，65% 的患者 (11/17) 有良好的结果 (mRS 0-2)。

结论

使用 Tigertriever13 进行机械血栓切除术似乎对 DMVO 是安全有效的。临床和解剖结果与近端闭塞患者的结果一致。