{
  "abstract": "Background The currently US Food and Drug Administration approved intracranial stent delivery system involves a multistep deployment process that requires the use of an exchange length microwire (ELW). In this study, we describe a single-step approach to deploy the Neuroform Atlas stent without the need for ELW or lesion re-access, using the MINI TREK II over-the-wire (OTW) semi-compliant coronary balloon.Methods We performed a retrospective review of prospectively maintained mechanical thrombectomy databases from two comprehensive stroke centers. The study included consecutive large vessel occlusion (LVO) stroke patients who underwent single-step angioplasty with the MINI TREK II OTW balloon followed by deployment of the Neuroform Atlas intracranial stent, without the use of an ELW.Results A total of 12 patients met the inclusion criteria. Among them, the median age was 67 years (IQR: 58–73) and 50% were female. Most patients had middle cerebral artery (MCA) M1 occlusion (75%). One-third of the patients received intravenous thrombolysis. All patients achieved successful reperfusion (modified Treatment in Cerebral Ischemia (mTICI) 2b/3) with a median of two passes. The median National Institutes of Health Stroke Scale (NIHSS) score decreased from 14 (IQR: 10–19) at baseline to 4 (IQR: 1–9) at discharge, and the median modified Rankin Scale (mRS) score was 1 (IQR: 1–4) at discharge and 3 (IQR: 2–4) at 90 days. None of the patients in this series experienced symptomatic intracranial hemorrhage, though two patients (16.7%) were dead at 90 days but there was no procedural-related mortality.Conclusions This preliminary experience demonstrates the technical feasibility and success of single-step deployment of the Neuroform Atlas stent following angioplasty with the MINI TREK II OTW balloon, without the need for an ELW or lesion re-access. Larger prospective studies with extended clinical follow-up are needed to validate these findings.",
  "authors": [
    {
      "affiliations": [
        "Neurology, UPMC Stroke Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA",
        "Neurosurgery, UPMC Stroke Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA"
      ],
      "name": "Alhamza R Al-Bayati"
    },
    {
      "affiliations": [
        "Neurology, UPMC Stroke Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA",
        "Neurosurgery, UPMC Stroke Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA"
      ],
      "name": "Mohamed F Doheim"
    },
    {
      "affiliations": [
        "Neurology, Emory University School of Medicine, Atlanta, Georgia, USA"
      ],
      "name": "Mahmoud H Mohammaden"
    },
    {
      "affiliations": [
        "Neurosurgery, UPMC Stroke Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA"
      ],
      "name": "Michael Lang"
    },
    {
      "affiliations": [
        "Neurosurgery, UPMC Stroke Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA"
      ],
      "name": "Bradley Gross"
    },
    {
      "affiliations": [
        "Neurology, Emory University School of Medicine, Atlanta, Georgia, USA",
        "Radiology, Emory University School of Medicine, Atlanta, Georgia, USA"
      ],
      "name": "Diogo C Haussen"
    },
    {
      "affiliations": [
        "Neurology, UPMC Stroke Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA",
        "Neurosurgery, UPMC Stroke Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA"
      ],
      "name": "Raul G Nogueira"
    }
  ],
  "title": "Feasibility of emergent single-step intracranial self-expanding stent deployment using over-the-wire coronary balloons in intracranial atherosclerosis-related large vessel occlusion thrombectomy",
  "uid": "8f93c5de-1c67-5820-b5ff-23345e5991ec"
}