Mechanical thromboembolectomy for acute ischemic stroke: comparison of the catch thrombectomy device and the Merci Retriever in vivo

Brekenfeld, Caspar; Schroth, Gerhard; El-Koussy, Marwan; Nedeltchev, Krassen; Reinert, Michael; Slotboom, Johannes; Gralla, Jan (2008). Mechanical thromboembolectomy for acute ischemic stroke: comparison of the catch thrombectomy device and the Merci Retriever in vivo. Stroke, 39(4), pp. 1213-9. Baltimore, Md.: Lippincott Williams & Wilkins 10.1161/STROKEAHA.107.495614

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BACKGROUND AND PURPOSE: The purpose of the study was to compare efficacy and potential complications of 2 commercially available devices for mechanical thromboembolectomy. METHODS: Devices were tested in an established animal model allowing the use of routine angiography catheters and thrombectomy devices. Radio-opaque thrombi were used for visualization of thrombus-device interaction during angiography. The Merci Retrieval System and the Catch Thromboembolectomy System were assessed each in 10 vessel occlusions. For every occluded vessel up to 5 retrieval attempts were performed. RESULTS: Sufficient recanalization was achieved with the Merci Retriever in 90% of occlusions, and with the Catch device recanalization was achieved in 70% of occlusions. Recanalization at the first attempt occurred significantly more often with the Merci Retriever compared to the Catch device (OR, 21; 95% CI, 1.78-248.11). Consequently, significantly more attempts (P=0.02) had to be performed with the Catch device; therefore, time to recanalization was longer. Thrombus fragmentations during retrieval were caused more often by the Catch device compared to the Merci Retriever (OR, 15.6; 95% CI, 1.73-140.84), resulting in a higher distal embolization rate. During retrieval both devices lost thrombotic material at the tip of the guide catheter, which was then aspirated in most cases. CONCLUSIONS: Both distal devices are effective for thromboembolectomy. To avoid loss of thrombotic material and distal embolization, the use of large luminal balloon guide catheters and aspiration during retrieval seems to be mandatory. The design of the Merci Retriever appears to be more efficient during thrombus mobilization and retrieval with less fragmentation compared to the Catch Thromboembolectomy System.

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
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery

UniBE Contributor:

Brekenfeld, Caspar; Schroth, Gerhard; El-Koussy, Marwan; Reinert, Michael; Slotboom, Johannes and Gralla, Jan

ISSN:

0039-2499

ISBN:

18309173

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:59

Last Modified:

04 May 2014 23:17

Publisher DOI:

10.1161/STROKEAHA.107.495614

PubMed ID:

18309173

Web of Science ID:

000254632900026

URI:

https://boris.unibe.ch/id/eprint/25431 (FactScience: 58502)

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