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    Quantitative Characterization of Recanalization and Distal Emboli with a Novel Thrombectomy Device

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    Authors
    Chueh, Juyu
    Marosfoi, Miklos G.
    Anagnostakou, Vania
    Arslanian, Rose
    Marks, Michael P.
    Gounis, Matthew J.
    UMass Chan Affiliations
    New England Center for Stroke Research
    Department of Radiology
    Document Type
    Journal Article
    Publication Date
    2020-11-11
    Keywords
    Acute ischemic stroke
    In vitro model
    Mechanical thrombectomy
    Analytical, Diagnostic and Therapeutic Techniques and Equipment
    Cardiovascular Diseases
    Nervous System Diseases
    Radiology
    
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    Link to Full Text
    https://doi.org/10.1007/s00270-020-02683-3
    Abstract
    PURPOSE: The first-pass effect during mechanical thrombectomy improves clinical outcomes regardless of first-line treatment approach, but current success rates for complete clot capture with one attempt are still less than 40%. We hypothesize that the ThrombX retriever (ThrombX Medical Inc.) can better engage challenging clot models during retrieval throughout tortuous vasculature in comparison with a standard stent retriever without increasing distal emboli. MATERIALS AND METHODS: Thrombectomy testing with the new retriever as compared to the Solitaire stent retriever was simulated in a vascular replica with hard and soft clot analogs to create a challenging occlusive burden. Parameters included analysis of distal emboli generated per clot type, along with the degree of recanalization (complete, partial or none) by retrieval device verified by angiography. RESULTS: The ThrombX device exhibited significantly higher rates of first-pass efficacy (90%) during hard clot retrieval in comparison with the control device (20%) (p < 0.009), while use of both techniques during soft clot retrieval resulted in equivalent recanalization. The soft clot model generated higher numbers of large emboli ( > 200 mum) across both device groups (p = 0.0147), and no significant differences in numbers of distal emboli were noted between the ThrombX and Solitaire techniques. CONCLUSIONS: Irrespective of clot composition, use of the ThrombX retriever demonstrated high rates of complete recanalization at first pass in comparison with a state-of-the-art stent retriever and proved to be superior in the hard clot model. Preliminary data suggest that risk of distal embolization associated with the ThrombX system is comparable to that of the control device.
    Source

    Chueh JY, Marosfoi MG, Anagnostakou V, Arslanian RA, Marks MP, Gounis MJ. Quantitative Characterization of Recanalization and Distal Emboli with a Novel Thrombectomy Device. Cardiovasc Intervent Radiol. 2020 Nov 11. doi: 10.1007/s00270-020-02683-3. Epub ahead of print. PMID: 33179161. Link to article on publisher's site

    DOI
    10.1007/s00270-020-02683-3
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/48463
    PubMed ID
    33179161
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    Link to Article in PubMed

    ae974a485f413a2113503eed53cd6c53
    10.1007/s00270-020-02683-3
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