Recanalization Therapy for Acute Stroke Using Penumbra System

Abstract

Objective: The purpose of this study was to evaluate the effectiveness and neurologic outcome of patients treated with the Penumbra system (PS) in the setting of acute ischemic stroke.

Methods: A total of 45 patients with acute ischemic stroke due to large-vessel occlusion were treated with the only PS. In 27 patients, mechanical recanalization was combined with iV t-PA thrombolysis. Recanalization was accessed with the thrombolysis in Cerebral Infarction (TICI) score.

Results: The mean patient age was 75.5 years. The average NIHSS score at hospital admission was 18.3. Successful recanalization (TICI score > IIb) was achieved in 73% of patients, whereas recanalization rates of M2 & ICA occlusion was 56% and 67%, respectively. Median time from onset to recanalization was 350 minutes (90–360 minutes) and puncture to recanalization time was 28.9 minutes (13–54 minutes). At follow-up, 36% of patients showed a mRS of < 2 at discharge, whereas only 11% of the patients with ICA and M2 occlusion had a favorable result. One patient died during hospitalization due to hemorrhagic infarction, and none of the deaths was device-related.

Conclusion: In this study, the PS was an effective device for mechanical recanalization. Successful recanalization with the PS was associated with significant improvement of functional outcome in patients experiencing ischemic stroke. For the patients with ICA and M2 occlusion, it is necessary to evaluate how to recanalize occlusive site.