• Monika Müller-Eschner, Se-Jong You, Kolja Jahnke, Sara Kammerer, Christian Foerch, Waltraud Pfeilschifter, Arne Lauer, Joachim Berkefeld, and Marlies Wagner.
• Institute of Neuroradiology, University Hospital Frankfurt, Goethe-University, Schleusenweg 2-16, 60528, Frankfurt, Germany. monika.mueller-eschner@kgu.de.
• Cardiovasc Intervent Radiol. 2019 Jan 1; 42 (1): 101-109.

Background And PurposeTo describe our first experience using a small stent retriever specifically designed for thrombectomy in cerebral arteries with a small caliber (Acandis APERIO® 3.5/28) in patients with acute ischemic stroke.Materials And MethodsAll patients with an acute ischemic stroke, who underwent endovascular recanalization using the APERIO® thrombectomy device with a diameter of 3.5 mm, were identified in retrospect and included in the present analysis. Demographic and clinical data as well as data on the procedures performed were collected (patient sex, mean age, NIHSS, mRS, TICI score, and complications).ResultsStent retriever-based thrombectomy with the Aperio® 3.5/28 alone (n = 10 vessels) or in combination with other devices (n = 13 vessels) was performed in 22 acute stroke patients with embolic occlusions of distal branches of the anterior and posterior circulations (median NIHSS = 8.5). For vessels treated with the Aperio® 3.5/28, we achieved a TICI 2b/3 reperfusion rate of 73.9%. One patient suffered a symptomatic intracerebral hemorrhage after thrombectomy; otherwise, no procedure-related complications were seen.ConclusionOur data suggest that mechanical thrombectomy of distal cerebral artery occlusions with the Aperio® 3.5/28 is feasible and in general safe, thus offering a promising option for endovascular stroke therapy. However, multicentric studies with larger patient cohorts are necessary to evaluate the clinical benefit.

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