Quantitative Characterization of Recanalization and Distal Emboli with a Novel Thrombectomy Device
Department of Radiology; New England Center for Stroke Research
Analytical, Diagnostic and Therapeutic Techniques and Equipment | Cardiovascular Diseases | Nervous System Diseases | Radiology
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.
Acute ischemic stroke, In vitro model, Mechanical thrombectomy
DOI of Published Version
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
Cardiovascular and interventional radiology
Chueh J, Marosfoi MG, Anagnostakou V, Arslanian R, Marks MP, Gounis MJ. (2020). Quantitative Characterization of Recanalization and Distal Emboli with a Novel Thrombectomy Device. Radiology Publications. https://doi.org/10.1007/s00270-020-02683-3. Retrieved from https://escholarship.umassmed.edu/radiology_pubs/568