Permanent implantation of the Solitaire device as a bailout technique for large vessel intracranial occlusions

J Neurointerv Surg. 2019 Feb;11(2):133-136. doi: 10.1136/neurintsurg-2017-013418. Epub 2018 Aug 28.

Abstract

The Solitaire (Medtronic Inc, Mansfield, Massachusetts, USA) is a stentriever device for endovascular treatment of acute ischemic stroke. Temporary endovascular bypass and mechanical thrombectomy are well-described applications of this device. However, few reports of permanent stent placement have been published. We present a series of five cases in which the Solitaire stent was implanted to restore distal flow after failure of conventional mechanical thrombectomy. All patients presented with large vessel occlusions with thrombi that were resistant to retrieval or suction-aspiration. Immediately after implantation the patients were given a loading dose of abciximab and then transitioned to dual antiplatelet therapy within 24 hours. Our series suggests that permanent deployment of the Solitaire may be considered as a bailout technique in the treatment of cerebral large vessel occlusion. Long-term antiplatelet therapy is required after deployment.

Keywords: stent; stroke; technique; thrombectomy.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Blood Vessel Prosthesis*
  • Brain Ischemia / diagnostic imaging
  • Brain Ischemia / surgery
  • Cerebrovascular Disorders / diagnostic imaging*
  • Cerebrovascular Disorders / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Self Expandable Metallic Stents*
  • Stroke / diagnostic imaging
  • Stroke / surgery
  • Thrombectomy / instrumentation
  • Thrombectomy / methods
  • Treatment Outcome