programma & abstracts - Nederlandse Vereniging voor Radiologie

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programma abstracts & abstracts
Results/conclusion: An example of segmentation results
and percentile plots (colored lines represent percentile-lines)
for a 69 year old male patient with suspected dementia
is provided in figure 1. Visual inspection suggests parietal
atrophy, which might be attributed to global cortical atrophy.
The automated analysis results show that overall brain
volume is appropriate for age (75th to 95th percentile), with
a strikingly low parietal lobe volume (37th percentile), confirming
the initially suspected parietal lobe atrophy.
A system prototype is currently under evaluation at our
radiology department. Future work aims to incorporate
automated analysis of microbleeds, shape of individual
brain structures and microstructural integrity using diffusionweighted
MRI sequences.
Figure 1: Results for a patient with suspected dementia.
O9.5
MECHANICAL THROMBECTOMY WITH
THE TREVO STENT DEVICE IN PROXIMAL
INTRACRANIAL ARTERIAL OCCLUSIONS
M.M.A.C. van Doorn 1 , R. van den Berg 1 , B. van der Kallen 2 ,
G.J. Lycklama à Nijeholt 2 , W. van Zwam 3 , Y.B. Roos 1 , P.J.
Nederkoorn 1 , M.E. Sprengers 1 , J. Bot 1 , J. Boiten 3 , R. van
Oostenbrugge 3 , A. van der Lugt 4 , D. Beumer 4 , P.S. Fransen 4 ,
D.W.J. Dippel 4 , C.B.L.M. Majoie 1
1
Academisch Medisch Centrum, Amsterdam
2
Medisch Centrum Haaglanden, Den Haag
3
Maastricht Universitair Medisch Centrum, Maastricht
4
Erasmus Medisch Centrum, Rotterdam
Background and Purpose: To evaluate the safety and
effectiveness of a self-expanding and fully retrievable stent
(Trevo; Concentric Medical Inc, Mountain View, CA, USA) in
revascularization of patients with acute ischemic stroke.
Methods: Prospective multicenter case series of 22 patients
with an acute ischemic stroke caused by a proximal intracranial
arterial occlusion treated with a fully retrievable stent
within the first 8 hours from symptom onset (median NIHSS
21 [range 13-28]). Thrombectomy was used as rescue therapy
in patients who were refractory to, had contraindications
for or were to late for IV rtPA. The occlusion site was the
middle cerebral artery in 7, terminus internal carotid artery
in 2, cervical internal carotid artery/middle cerebral artery in
4 and basilar artery in 9 patients. Complications related to
the procedure and outcome at 3-6 months were assessed.
Results: Stent placement was feasible in all procedures
and successful recanalization defined as thrombosis in cerebral
ischemia (TICI) grade 2b or 3 was achieved in 18 of 22
treated vessels (82%). The mean number of passes for maximal
recanalization was 2 (range 1-5). The median time from
groin puncture to recanalization was 110 minutes (range
26 – 199). One significant procedural event occurred (carotid
artery occlusion after stent removal). 33% of all patients had
a good outcome (mRS 0-2), 0% moderate outcome (mRS 3),
67% poor outcome (mRS 4-6).
Conclusions: These results suggest that with the Trevo
device, clots can be safely and effectively removed from
intracranial large vessel occlusions in acute ischemic stroke.
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