Open embolectomy of large vessel occlusion in the endovascular era: Results of a 12-year single-center experience.

Open embolectomy of large vessel occlusion in the endovascular era: Results of a 12-year single-center experience.

World Neurosurg. 2017 Mar 02;:

Authors: Horiuchi T, Nitta J, Miyaoka Y, Nagm A, Tsutsumi K, Ito K, Hongo K

Abstract
BACKGROUND: and Purpose. Mechanical endovascular embolectomy using stent retrievers has gained popularity for the treatment of large vessel occlusion in acute ischemic stroke. Open embolectomy as direct surgical treatment has been limited, likely due to a fear of technical difficulty, therapeutic time window and time consuming. However, open embolectomy resulted in a high complete recanalization rate with safety profile.
METHODS: The authors retrospectively reviewed the clinical and radiographic records of patients who underwent open embolectomy for major artery occlusion at acute stage. The clinical features, complications, and outcome of these patients were analyzed.
RESULTS: From January 2004 to September 2016, 153 patients who underwent 157-open embolectomy for major artery occlusion. Complete recanalization was achieved in 96.2% of patients. Favorable outcome was observed in 43.9%. The cerebral aneurysm along the occluded artery was observed in 11 patients with 12 aneurysms.
CONCLUSIONS: Open embolectomy is a safe and durable method of cerebral recanalization in patients with embolic stroke and can be considered as a potential treatment if endovascular embolectomy cannot be applied due to some reasons. The actual occluded artery information in the present study will be useful for endovascular surgeon to prevent the complication.

PMID: 28263932 [PubMed - as supplied by publisher]

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