Title

An in vitro evaluation of distal emboli following Lazarus Cover-assisted stent retriever thrombectomy

UMMS Affiliation

Department of Radiology

Date

2-1-2017

Document Type

Article

Disciplines

Cardiovascular Diseases | Nervous System Diseases | Radiology

Abstract

BACKGROUND: Formation of clot fragments during mechanical thrombectomy for acute ischemic stroke can occlude the distal vasculature, which may reduce the rate of good clinical outcome.

OBJECTIVE: To examine the hypothesis that distal embolization can be reduced using stent retriever thrombectomy in combination with Lazarus Cover technology.

METHODS: Hard, fragment-prone clots were used to create middle cerebral artery occlusions in a vascular phantom. Three different treatment strategies using Solitaire FR included: group 1-proximal flow control with an 8F balloon guide catheter (BGC), group 2-thrombectomy through a 6F conventional guide catheter (CGC), and group 3-a similar thrombectomy procedure to group 2 but including the Lazarus Cover device. The primary endpoint was distal emboli quantified by the number and size of the clot debris.

RESULTS: The Cover-assisted stent retriever thrombectomy significantly reduced the generation of clot fragments >200 mum as compared with thrombectomy with a CGC, and was similar to the BGC group. Particle size distribution recanalization, with only one failed recanalization with partial clot retention after three passes in one experiment of stent retriever thrombectomy through a CGC. Use of the adjunctive Cover device did not prolong the procedure as compared with control groups.

CONCLUSIONS: For a fragment-prone clot, Solitaire thrombectomy in conjunction with the Cover device may lower the risk of distal embolization and is comparable to BGC-protected embolectomy.

Rights and Permissions

Citation: J Neurointerv Surg. 2017 Feb;9(2):183-187 Epub 2016 Feb 26. Link to article on publisher's site

Related Resources

Link to Article in PubMed

Keywords

Device, Stroke, Thrombectomy

PubMed ID

26919972