One-Year MR Angiographic and Clinical Follow-Up after Intracranial Mechanical Thrombectomy Using a Stent Retriever Device.

François Eugène 1 Jean-Yves Gauvrit 1 Jean-Christophe Ferré 2, 1 Jean-Christophe Gentric 3, 1 Amel Besseghir 1 Thomas Ronzière 4 Hélène Raoult 1, *
* Corresponding author
2 VisAGeS - Vision, Action et Gestion d'informations en Santé
INSERM - Institut National de la Santé et de la Recherche Médicale : U746, Inria Rennes – Bretagne Atlantique , IRISA-D5 - SIGNAUX ET IMAGES NUMÉRIQUES, ROBOTIQUE
Abstract : BACKGROUND AND PURPOSE: Little is known about the consequences of arterial wall damage that may be due to mechanical endovascular thrombectomy. Our aim was to perform 1-year MR angiographic and clinical follow-up of patients treated with mechanical endovascular thrombectomy using the Solitaire device. MATERIALS AND METHODS: Patients with stroke treated between August 2010 and July 2012 were prospectively evaluated with a minimum follow-up of 1 year after mechanical endovascular thrombectomy. Angiographic follow-up was performed on a 3T MR imaging scanner and included intracranial artery TOF MRA and supra-aortic artery gadolinium-enhanced MRA. Images were assessed to detect arterial abnormalities (stenosis, occlusion, dilation) and were compared with the final post-mechanical endovascular thrombectomy run to differentiate delayed and pre-existing abnormalities. Clinical evaluation was performed with the mRS and the 36-Item Short-Form Health Survey questionnaire quality-of-life scale. RESULTS: Thirty-nine patients were angiographically assessed at the mean term of 19 ± 4 months. MRA showed intracranial artery abnormalities in 10 patients, including 5 delayed intracranial artery abnormalities in 4 patients (4 stenoses and 1 dilation), 4 cases of pre-existing intracranial artery stenosis, and 2 occlusions. Pre-existing etiologic cervical artery stenosis or occlusion was observed in 2 patients. All these patients remained asymptomatic during the follow-up period. A significant clinical improvement was observed at 1-year follow-up in comparison with 3-month follow-up (P < .0001), with a good outcome achieved in 62.5% of patients and an acceptable quality of life restored. CONCLUSIONS: One-year follow-up identifies delayed asymptomatic arterial abnormalities in patients treated with the Solitaire device.
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Submitted on : Monday, January 12, 2015 - 3:18:46 PM
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François Eugène, Jean-Yves Gauvrit, Jean-Christophe Ferré, Jean-Christophe Gentric, Amel Besseghir, et al.. One-Year MR Angiographic and Clinical Follow-Up after Intracranial Mechanical Thrombectomy Using a Stent Retriever Device.. American Journal of Neuroradiology, American Society of Neuroradiology, 2014, 36, pp.126-132. ⟨10.3174/ajnr.A4071⟩. ⟨inserm-01102328⟩

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