Objectives: We present our initial experience of endovascular treatment (EVT) in patients with acute ischemic stroke (AIS).

Background: Several randomized trials have indicated a benefit from endovascular therapy in selected ischemic stroke patients.

Methods: During last 3 years we performed EVT of 18 consecutive AIS patients National Institutes of Health Stroke Scale 13.6 ±4.8 at presentation. The following EVT methods were applied: (A) mechanical thrombaspiration with Penumbra system (PS) alone in 4 patients; (B) combination of PS thrombaspiration plus balloon angioplasty (PTA) in 4 patients; (C) combination of wire recanalization, PTA and supraselective fibrinolysis with low dose t-PA in 4 patients, and (D) supraselective intra-arterial fibrinolysis alone in 5 patients. Stenting of the extracranial ICA and consecutive distal balloon PTA or PS thrombectomy in MCA was performed in other 2 patients. The target occluded arteries were: middle cerebral artery (MCA), extracranial internal carotid, pericalosal artery, basilar artery, vertebral artery and 2 patients with ACA/MCA occlusion.

Results: The mean symptom onset-to-reperfusion time was 252 ±116 min. Post-interventional TICI 2b-3 flow was achieved in 72.2%. %. In patients treated with different methods, the results were respectively: A–75%, B-25%, C-80%, D-100%. A poor recanalization (TICI≤2) had 4 patients (22.2%). We observed mortality in only one patient (5.6%), malignant MCA infarct in 2 patients, and two patients developed nonfatal intracerebral hemorrhage. Modified Rankin Scale score 0-2 (at 90 days) was observed in 9 patients (50%).

Conclusions: Our initial experience with EVT of AIS is encouraging, with a relatively moderate to high rate of successful angiographic recanalization and good clinical results.