Title
Early detachment of the Solitaire stent during thrombectomy retrieval: an in vitro investigation
UMMS Affiliation
Department of Radiology; New England Center for Stroke Research
Publication Date
2015-02-01
Document Type
Article
Disciplines
Neurology | Radiology
Abstract
OBJECTIVE: To elucidate the early detachment of the Solitaire stent during mechanical thrombectomy, we tested the stent in vitro under various conditions and evaluated with microscopy.
METHODS: A total of five stents were tested. Using a dynamic mechanical analysis machine, we calculated the tensile force needed for separation of the four stents from the pusher wire. Stent Nos 1 and 2 were tested without any prior manipulation. During the retraction test, no sheathing around the stent-wire junction was applied to stent No 1 whereas stent No 2 was partially covered with a sheath in accordance with instructions for use (IFU) recommendations. Stent No 3 was tested after deployment and retrieval were performed three times in an in vitro vascular replica with sheathing during retrieval. Stent No 4 was tested after one deployment and retrieval using the same replica as in stent No 3 without sheathing. In addition, forward pushing force was applied intentionally during retraction to induce excessive bending of the stent. Stent No 5 was pulled apart by both hands. After separation, stent tips and pusher wires were studied for all stents under the microscope.
RESULTS: The tensile force needed for separation was about 6 N for stent Nos 1, 2, and 3, and about 4 N for stent No 4. All of the stents showed separation at the proximal marker, not at the detachment zone.
CONCLUSIONS: Detachment of the Solitaire stent during thrombectomy can be due to separation around or inside the proximal marker. Adherence to the manufacturer's IFU of partial re-sheathing during retraction and not using the device for more than two passes might decrease the possibility of such device failure.
DOI of Published Version
10.1136/neurintsurg-2013-010942
Source
J Neurointerv Surg. 2015 Feb;7(2):114-7. Epub 2014 Jan 16. Link to article on publisher's site
Journal/Book/Conference Title
Journal of neurointerventional surgery
Related Resources
PubMed ID
24435960
Repository Citation
Kwon H, Chueh J, Puri AS, Koh H. (2015). Early detachment of the Solitaire stent during thrombectomy retrieval: an in vitro investigation. Radiology Publications and Presentations. https://doi.org/10.1136/neurintsurg-2013-010942. Retrieved from https://escholarship.umassmed.edu/radiology_pubs/251