Mechanical thrombolysis in acute ischemic stroke with endovascular photoacoustic recanalization

Ansgar Berlis, Helmi Lutsep, Stan Barnwell, Alexander Norbash, Lawrence Wechsler, Charles A. Jungreis, Andrew Woolfenden, Gary Redekop, Marius Hartmann, Martin Schumacher

Research output: Contribution to journalArticle

126 Citations (Scopus)

Abstract

Background and Purpose - We present the results of endovascular photoacoustic recanalization (EPAR) treatment for acute ischemic stroke from the Safety and Performance Study at 6 centers in Europe and North America. The objectives of mechanical thrombolysis are rapid vessel recanalization and minimal use of chemical thrombolysis. Methods - This study was a prospective, nonrandomized study. The National Institutes of Health Stroke Scale (NIHSS) score and the modified Rankin Scale (mRS) score were recorded before treatment. The presence of recanalization was assessed by angiography. To measure outcome, follow-up examinations were performed at 24 hours, 7 days, and 30 days after stroke onset. Results - Thirty-four patients (median NIHSS 19) were enrolled. Ten patients had internal carotid artery occlusion, 12 patients had middle cerebral artery occlusion, 11 patients had vertebrobasilar occlusion, and 1 patient had posterior cerebral artery occlusion. The overall recanalization rate was 41.1% (14/34). Complete EPAR treatment was possible in 18 patients (median NIHSS 18), with vessel recanalization in 11 patients (61.1%) after EPAR. The average lasing time was 9.65 minutes. Incomplete EPAR treatment (16/34, median NIHSS 19) was defined as intention to treat with EPAR and that the EPAR microcatheter entered the patient. Additional treatment with intraarterial application of rTPA occurred in 13 patients. An adverse event associated with use of the device occurred in 1 patient. Symptomatic hemorrhages occurred in 2 patients (5.9%). The mortality rate was 38.2%. Conclusions - This study demonstrates the safety and technical feasibility of EPAR. This new technique may provide another treatment option in the therapeutic armamentarium for patients with acute ischemic stroke.

Original languageEnglish (US)
Pages (from-to)1112-1116
Number of pages5
JournalStroke
Volume35
Issue number5
DOIs
StatePublished - May 2004
Externally publishedYes

Fingerprint

Mechanical Thrombolysis
Stroke
National Institutes of Health (U.S.)
Therapeutics
Posterior Cerebral Artery
Safety
Middle Cerebral Artery Infarction
Internal Carotid Artery
North America

Keywords

  • Endovascular therapy
  • Laser
  • Stroke, acute
  • Stroke, ischemic
  • Thrombolysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Neuroscience(all)

Cite this

Berlis, A., Lutsep, H., Barnwell, S., Norbash, A., Wechsler, L., Jungreis, C. A., ... Schumacher, M. (2004). Mechanical thrombolysis in acute ischemic stroke with endovascular photoacoustic recanalization. Stroke, 35(5), 1112-1116. https://doi.org/10.1161/01.STR.0000124126.17508.d3

Mechanical thrombolysis in acute ischemic stroke with endovascular photoacoustic recanalization. / Berlis, Ansgar; Lutsep, Helmi; Barnwell, Stan; Norbash, Alexander; Wechsler, Lawrence; Jungreis, Charles A.; Woolfenden, Andrew; Redekop, Gary; Hartmann, Marius; Schumacher, Martin.

In: Stroke, Vol. 35, No. 5, 05.2004, p. 1112-1116.

Research output: Contribution to journalArticle

Berlis, A, Lutsep, H, Barnwell, S, Norbash, A, Wechsler, L, Jungreis, CA, Woolfenden, A, Redekop, G, Hartmann, M & Schumacher, M 2004, 'Mechanical thrombolysis in acute ischemic stroke with endovascular photoacoustic recanalization', Stroke, vol. 35, no. 5, pp. 1112-1116. https://doi.org/10.1161/01.STR.0000124126.17508.d3
Berlis, Ansgar ; Lutsep, Helmi ; Barnwell, Stan ; Norbash, Alexander ; Wechsler, Lawrence ; Jungreis, Charles A. ; Woolfenden, Andrew ; Redekop, Gary ; Hartmann, Marius ; Schumacher, Martin. / Mechanical thrombolysis in acute ischemic stroke with endovascular photoacoustic recanalization. In: Stroke. 2004 ; Vol. 35, No. 5. pp. 1112-1116.
@article{0cf61dcadb134838add4d6878560fd6a,
title = "Mechanical thrombolysis in acute ischemic stroke with endovascular photoacoustic recanalization",
abstract = "Background and Purpose - We present the results of endovascular photoacoustic recanalization (EPAR) treatment for acute ischemic stroke from the Safety and Performance Study at 6 centers in Europe and North America. The objectives of mechanical thrombolysis are rapid vessel recanalization and minimal use of chemical thrombolysis. Methods - This study was a prospective, nonrandomized study. The National Institutes of Health Stroke Scale (NIHSS) score and the modified Rankin Scale (mRS) score were recorded before treatment. The presence of recanalization was assessed by angiography. To measure outcome, follow-up examinations were performed at 24 hours, 7 days, and 30 days after stroke onset. Results - Thirty-four patients (median NIHSS 19) were enrolled. Ten patients had internal carotid artery occlusion, 12 patients had middle cerebral artery occlusion, 11 patients had vertebrobasilar occlusion, and 1 patient had posterior cerebral artery occlusion. The overall recanalization rate was 41.1{\%} (14/34). Complete EPAR treatment was possible in 18 patients (median NIHSS 18), with vessel recanalization in 11 patients (61.1{\%}) after EPAR. The average lasing time was 9.65 minutes. Incomplete EPAR treatment (16/34, median NIHSS 19) was defined as intention to treat with EPAR and that the EPAR microcatheter entered the patient. Additional treatment with intraarterial application of rTPA occurred in 13 patients. An adverse event associated with use of the device occurred in 1 patient. Symptomatic hemorrhages occurred in 2 patients (5.9{\%}). The mortality rate was 38.2{\%}. Conclusions - This study demonstrates the safety and technical feasibility of EPAR. This new technique may provide another treatment option in the therapeutic armamentarium for patients with acute ischemic stroke.",
keywords = "Endovascular therapy, Laser, Stroke, acute, Stroke, ischemic, Thrombolysis",
author = "Ansgar Berlis and Helmi Lutsep and Stan Barnwell and Alexander Norbash and Lawrence Wechsler and Jungreis, {Charles A.} and Andrew Woolfenden and Gary Redekop and Marius Hartmann and Martin Schumacher",
year = "2004",
month = "5",
doi = "10.1161/01.STR.0000124126.17508.d3",
language = "English (US)",
volume = "35",
pages = "1112--1116",
journal = "Stroke",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Mechanical thrombolysis in acute ischemic stroke with endovascular photoacoustic recanalization

AU - Berlis, Ansgar

AU - Lutsep, Helmi

AU - Barnwell, Stan

AU - Norbash, Alexander

AU - Wechsler, Lawrence

AU - Jungreis, Charles A.

AU - Woolfenden, Andrew

AU - Redekop, Gary

AU - Hartmann, Marius

AU - Schumacher, Martin

PY - 2004/5

Y1 - 2004/5

N2 - Background and Purpose - We present the results of endovascular photoacoustic recanalization (EPAR) treatment for acute ischemic stroke from the Safety and Performance Study at 6 centers in Europe and North America. The objectives of mechanical thrombolysis are rapid vessel recanalization and minimal use of chemical thrombolysis. Methods - This study was a prospective, nonrandomized study. The National Institutes of Health Stroke Scale (NIHSS) score and the modified Rankin Scale (mRS) score were recorded before treatment. The presence of recanalization was assessed by angiography. To measure outcome, follow-up examinations were performed at 24 hours, 7 days, and 30 days after stroke onset. Results - Thirty-four patients (median NIHSS 19) were enrolled. Ten patients had internal carotid artery occlusion, 12 patients had middle cerebral artery occlusion, 11 patients had vertebrobasilar occlusion, and 1 patient had posterior cerebral artery occlusion. The overall recanalization rate was 41.1% (14/34). Complete EPAR treatment was possible in 18 patients (median NIHSS 18), with vessel recanalization in 11 patients (61.1%) after EPAR. The average lasing time was 9.65 minutes. Incomplete EPAR treatment (16/34, median NIHSS 19) was defined as intention to treat with EPAR and that the EPAR microcatheter entered the patient. Additional treatment with intraarterial application of rTPA occurred in 13 patients. An adverse event associated with use of the device occurred in 1 patient. Symptomatic hemorrhages occurred in 2 patients (5.9%). The mortality rate was 38.2%. Conclusions - This study demonstrates the safety and technical feasibility of EPAR. This new technique may provide another treatment option in the therapeutic armamentarium for patients with acute ischemic stroke.

AB - Background and Purpose - We present the results of endovascular photoacoustic recanalization (EPAR) treatment for acute ischemic stroke from the Safety and Performance Study at 6 centers in Europe and North America. The objectives of mechanical thrombolysis are rapid vessel recanalization and minimal use of chemical thrombolysis. Methods - This study was a prospective, nonrandomized study. The National Institutes of Health Stroke Scale (NIHSS) score and the modified Rankin Scale (mRS) score were recorded before treatment. The presence of recanalization was assessed by angiography. To measure outcome, follow-up examinations were performed at 24 hours, 7 days, and 30 days after stroke onset. Results - Thirty-four patients (median NIHSS 19) were enrolled. Ten patients had internal carotid artery occlusion, 12 patients had middle cerebral artery occlusion, 11 patients had vertebrobasilar occlusion, and 1 patient had posterior cerebral artery occlusion. The overall recanalization rate was 41.1% (14/34). Complete EPAR treatment was possible in 18 patients (median NIHSS 18), with vessel recanalization in 11 patients (61.1%) after EPAR. The average lasing time was 9.65 minutes. Incomplete EPAR treatment (16/34, median NIHSS 19) was defined as intention to treat with EPAR and that the EPAR microcatheter entered the patient. Additional treatment with intraarterial application of rTPA occurred in 13 patients. An adverse event associated with use of the device occurred in 1 patient. Symptomatic hemorrhages occurred in 2 patients (5.9%). The mortality rate was 38.2%. Conclusions - This study demonstrates the safety and technical feasibility of EPAR. This new technique may provide another treatment option in the therapeutic armamentarium for patients with acute ischemic stroke.

KW - Endovascular therapy

KW - Laser

KW - Stroke, acute

KW - Stroke, ischemic

KW - Thrombolysis

UR - http://www.scopus.com/inward/record.url?scp=11144353716&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=11144353716&partnerID=8YFLogxK

U2 - 10.1161/01.STR.0000124126.17508.d3

DO - 10.1161/01.STR.0000124126.17508.d3

M3 - Article

C2 - 15017011

AN - SCOPUS:11144353716

VL - 35

SP - 1112

EP - 1116

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 5

ER -