Abstract
Objective: Initial clinical experience with mechanical disruption of clots is reported using a specially modified microguidewire to treat acute ischemic stroke. This strategy was adopted to increase the recanalization rate without increasing risk of intracerebral hemorrhage.
Methods: The coil spring of the wire tip was manually uncoiled for indentation and manipulated to grind the clots in the occluded artery.
Results: Immediate and complete recanalization was achieved in all 5 patients with acute thromboembolic occlusion of the M2 or more peripheral segment of the middle cerebral artery. No vessel injury or intracranial hemorrhage was observed. All patients recovered to a modified Rankin scale score of 0 or 1.
Conclusion: Mechanical clot disruption for acute M2 or more distal occlusion using the specially modified microguidewire is a potentially useful treatment with a high rate of vessel recanalization and clinical improvement. This strategy may reduce the risk of hemorrhagic complication observed with thrombolytic therapy. Further examination and device refinement are encouraged.
