Nordmeyer, Hannes; Belachew, Nebiyat Filate; Phung, Timo Huan; Gralla, Jan; Molina Gil, Sara; Douglas, Andrew; Neuhaus, Stephanie; Haage, Patrick; Doyle, Karen; Mordasini, Pasquale (2023). NIMBUS geometric clot extractor for challenging clots: Real-world clinical experience and clot composition. (In Press). Interventional neuroradiology, p. 15910199231167912. Sage Publications 10.1177/15910199231167912
Full text not available from this repository. (Request a copy)PURPOSE
Revascularization rates following mechanical thrombectomy (MT) for acute ischemic stroke (AIS) remain suboptimal for patients with fibrin-rich, recalcitrant clots. The NIMBUS Geometric Clot Extractor has demonstrated promising in vitro revascularization rates using fibrin-rich clot analogs. This study assessed the retrieval rate and composition of clot using NIMBUS in a clinical setting.
METHODS
This retrospective study included patients who underwent MT with NIMBUS at two high-volume stroke centers between December 2019 and May 2021. NIMBUS was used for clots deemed challenging to remove at the interventionalist's discretion. At one of the centers, per pass clot was collected for histological analysis by an independent lab.
RESULTS
A total of 37 patients (mean age 76.87 ± 11.73 years; 18 female; mean time from stroke onset 11.70 ± 6.41 h) were included. NIMBUS was used as first and second-line device in 5 and 32 patients, respectively. The main reason for using NIMBUS (32/37) was the failure of standard MT techniques after a mean 2.86 ± 1.48 number of passes. Substantial reperfusion (mTICI ≥2b) was achieved in 29/37 patients (78.4%) with a mean of 1.81 ± 1.00 NIMBUS passes (mean 4.68 ± 1.68 passes with all devices), and NIMBUS was the final device used in 79.3% (23/29) of those cases. Clot specimens from 18 cases underwent composition analysis. Fibrin and platelets represented 31.4 ± 13.7% and 28.8 ± 18.8% of clot components; 34.4 ± 19.5% were red blood cells.
CONCLUSIONS
In this series, NIMBUS was effective in removing tough clots rich in fibrin and platelets in challenging real-world situations.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology |
UniBE Contributor: |
Gralla, Jan |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1591-0199 |
Publisher: |
Sage Publications |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
04 Apr 2023 16:12 |
Last Modified: |
05 Apr 2023 00:17 |
Publisher DOI: |
10.1177/15910199231167912 |
PubMed ID: |
37011914 |
Uncontrolled Keywords: |
Ischemic stroke fibrin mechanical thrombolysis thrombosis |
URI: |
https://boris.unibe.ch/id/eprint/181489 |
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