Initial Experience with the Solitaire X 3 mm Stent Retriever for the Treatment of Distal Medium Vessel Occlusions

Ntoulias, Nikos; Brehm, Alex; Tsogkas, Ioannis; Jesser, Jessica; Caragliano, Antonio Armando; Demerath, Theo; van Es, A. C. G. M.; Gruber, Phillip; Vega, Pedro; Lüttich, Alex; Nayak, Sanjeev; Fandiño, Eduardo; Ribo, Marc; Rodriguez Paz, Carlos Manuel; Möhlenbruch, Markus A.; Tessitore, Agostino; Remonda, Luca; Murias, Eduardo; Blackham, Kristine Ann; Psychogios, Marios-Nikos

Abstract

Endovascular therapy (EVT) is the standard treatment for ischemic stroke caused by a large vessel occlusion (LVO). The effectiveness of EVT for distal medium vessel occlusions (MDVOs) is still uncertain, but newer, smaller devices show potential for EVT in MDVOs. The new Solitaire X 3 mm device offers a treatment option for MDVOs. Our study encompassed consecutive cases of primary and secondary MDVOs treated with the Solitaire X 3 mm stent-retriever as first-line EVT device between January and December 2022 at 12 European stroke centers. The primary endpoint was a first-pass near-complete or complete reperfusion, defined as a modified treatment in cerebral infarction (mTICI) score of 2c/3. Additionally, we examined reperfusion results, National Institutes of Health Stroke Scale (NIHSS) scores at 24 h and discharge, device malfunctions, complications and procedural technical parameters. Sixty-eight patients (38 women, mean age 72 ± 14 years) were included in our study. Median NIHSS at admission was 11 (IQR 6–16). In 53 (78%) cases, a primary combined approach was used as the frontline technique. Among all enrolled patients, first-pass mTICI 2c/3 was achieved in 22 (32%) and final mTICI 2c/3 in 46 (67.6%) patients after a median of 1.5 (IQR 1–2) passes. Final reperfusion mTICI 2b/3 was observed in 89.7% of our cases. We observed no device malfunctions. Median NIHSS at discharge was 2 (IQR 0–4), and no symptomatic intracranial hemorrhages were reported. Based on our analysis, the utilization of the Solitaire X 3 mm device appears to be both effective and safe for performing EVT in cases of MDVO stroke.

Citation

Ntoulias, N., Brehm, A., Tsogkas, I., Jesser, J., Caragliano, A. A., Demerath, T., …Psychogios, M. (in press). Initial Experience with the Solitaire X 3 mm Stent Retriever for the Treatment of Distal Medium Vessel Occlusions. Journal of Clinical Medicine, 12(23), 7289. https://doi.org/10.3390/jcm12237289

• Journal Article Type: Article
• Acceptance Date: Nov 20, 2023
• Online Publication Date: Nov 24, 2023
• Deposit Date: Dec 11, 2023
• Journal: Journal of Clinical Medicine
• Electronic ISSN: 2077-0383
• Publisher: MDPI
• Peer Reviewed: Peer Reviewed
• Volume: 12
• Issue: 23
• Pages: 7289
• DOI: https://doi.org/10.3390/jcm12237289
• Keywords: stroke, endovascular thrombectomy, distal medium vessel occlusions