Experimental Evaluation of Immediate Recanalization Effect and Recanalization Efficacy of a New Thrombus Retriever for Acute Stroke Treatment In Vivo

Mordasini, P.; Brekenfeld, C.; Byrne, J. V.; Fischer, Urs; Arnold, M.; Jung, S.; Schroth, G.; Gralla, J. (2013). Experimental Evaluation of Immediate Recanalization Effect and Recanalization Efficacy of a New Thrombus Retriever for Acute Stroke Treatment In Vivo. American journal of neuroradiology AJNR, 34(1), pp. 153-158. Oak Brook, Ill.: American Society of Neuroradiology 10.3174/ajnr.A3275

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BACKGROUND AND PURPOSE: Currently, several new stent retriever devices for acute stroke treatment are under development and early clinical evaluation. Preclinical testing under standardized conditions is an important first step to evaluate the technical performance and potential of these devices. The aim of this study was to evaluate the immediate recanalization effect, recanalization efficacy, thrombus-device interaction, and safety of a new stent retriever intended for thrombectomy in patients with acute stroke. MATERIAL AND METHODS: The pREset thrombectomy device (4 × 20 mm) was evaluated in 16 vessel occlusions in an established swine model. Radiopaque thrombi (10-mm length) were used for visualization of thrombus-device interaction during application and retrieval. Flow-restoration effect immediately after deployment and after 5-minute embedding time before retrieval, recanalization rate after retrieval, thromboembolic events, and complications were assessed. High-resolution FPCT was performed to illustrate thrombus-device interaction during the embedding time. RESULTS: Immediate flow restoration was achieved in 75% of occlusions. An increase or stable percentage of recanalizations during embedding time before retrieval was seen in 56.3%; a decrease, in 12.5%; reocclusion of a previously recanalized vessel, in 18.8%; and no recanalization effect at all, in 12.5%. Complete recanalization (TICI 3) after retrieval was achieved in 93.8%; partial recanalization (TICI 2b), in 6.2%. No distal thromboembolic events were observed. High-resolution FPCT illustrated entrapment of the thrombus between the stent struts and compression against the contralateral vessel wall, leading to partial flow restoration. During retrieval, the thrombus was retained in a straight position within the stent struts. CONCLUSIONS: In this experimental study, the pREset thrombus retriever showed a high recanalization rate in vivo. High-resolution FPCT allows detailed illustration of the thrombus-device interaction during embedding time and is advocated as an add-on tool to the animal model used in this study.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

UniBE Contributor:

Mordasini, Pasquale; Brekenfeld, Caspar; Fischer, Urs; Arnold, Marcel; Jung, Simon; Schroth, Gerhard and Gralla, Jan

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0195-6108

Publisher:

American Society of Neuroradiology

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:30

Last Modified:

29 Dec 2017 10:19

Publisher DOI:

10.3174/ajnr.A3275

PubMed ID:

22837308

Web of Science ID:

000313545200026

BORIS DOI:

10.7892/boris.11577

URI:

https://boris.unibe.ch/id/eprint/11577 (FactScience: 217779)

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