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Stent retriever device

Osama O Zaidat, Nils H Mueller-Kronast, Ameer E Hassan, Diogo C Haussen, Ashutosh P Jadhav, Michael T Froehler, Reza Jahan, Mohammad Ali Aziz-Sultan, Richard P Klucznik, Jeffrey L Saver, Frank R Hellinger, Dileep R Yavagal, Tom L Yao, Rishi Gupta, Coleman O Martin, Hormozd Bozorgchami, Ritesh Kaushal, Raul G Nogueira, Ravi H Gandhi, Eric C Peterson, Shervin Dashti, Curtis A Given, Brijesh P Mehta, Vivek Deshmukh, Sidney Starkman, Italo Linfante, Scott H McPherson, Peter Kvamme, Thomas J Grobelny, Muhammad Shazam Hussain, Ike Thacker, Nirav Vora, Peng Roc Chen, Stephen J Monteith, Robert D Ecker, Clemens M Schirmer, Eric Sauvageau, Alex Bou Chebl, Colin P Derdeyn, Lucian Maidan, Aamir Badruddin, Adnan H Siddiqui, Travis M Dumont, Abdulnasser Alhajeri, Muhammad A Taqi, Khaled Asi, Jeffrey Carpenter, Alan Boulos, Gaurav Jindal, Ajit S Puri, Rohan Chitale, Eric M Deshaies, David Robinson, David F Kallmes, Blaise W Baxter, Mouhammed Jumaa, Peter Sunenshine, Aniel Majjhoo, Joey D English, Shuichi Suzuki, Richard D Fessler, Josser Delgado-Almandoz, Jerry C Martin, David S Liebeskind
Background and Purpose- Mechanical thrombectomy has been shown to improve clinical outcomes in patients with acute ischemic stroke. However, the impact of balloon guide catheter (BGC) use is not well established. Methods- STRATIS (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke) was a prospective, multicenter study of patients with large vessel occlusion treated with the Solitaire stent retriever as first-line therapy. In this study, an independent core laboratory, blinded to the clinical outcomes, reviewed all procedures and angiographic data to classify procedural technique, target clot location, recanalization after each pass, and determine the number of stent retriever passes...
February 19, 2019: Stroke; a Journal of Cerebral Circulation
Christopher T Primiani, Angel Chinea Vicente, Michael T Brannick, Aquilla S Turk, J Mocco, Elad I Levy, Adnan H Siddiqui, Maxim Mokin
BACKGROUND: The two most common approaches to thrombectomy of emergent large vessel occlusion (direct aspiration and primary stent retriever thrombectomy) have been extensively studied; however, the detailed benefit and risk comparison is largely unknown. OBJECTIVE: To conduct a systematic review and meta-analysis to compare radiographic and clinical outcomes between the use of primary stent retrievers and direct aspiration in management of acute ischemic stroke...
February 13, 2019: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Dong-Hun Kang, Yang-Ha Hwang
Endovascular thrombectomy (EVT) as the standard care for acute stroke due to large vessel occlusion has recently been validated through several randomized controlled trials (RCTs). Contact aspiration (CA) and stent retriever (SR) are the two major EVT methods currently used. Because the RCTs have mostly evaluated SR devices, there was a demand to test CA in relation to SR as a frontline EVT treatment method. Recently, the Contact Aspiration vs Stent Retriever for Successful Recanalization (ASTER) study, the first RCT to compare CA and SR, demonstrated similar efficacy between them as a frontline EVT for patients with large vessel occlusions...
January 2019: Journal of Stroke
Iacopo Valente, Sergio Nappini, Leonardo Renieri, Alessandro Pedicelli, Emilio Lozupone, Cesare Colosimo, Salvatore Mangiafico, Nicola Limbucci
INTRODUCTION: We report our experience with the novel stent-type clot-retrieval device EmboTrap II for the revascularization of large artery occlusions in acute ischaemic stroke. MATERIALS AND METHODS: Twenty-nine patients with acute ischaemic stroke due to large artery occlusion underwent mechanical thrombectomy with the new EmboTrap II in two Italian centres. Clinical, procedural and radiological data were collected. Angiographic results and neurological outcomes were analysed...
February 4, 2019: Interventional Neuroradiology
Atsushi Uyama, Atsushi Fujita, Takeshi Kondo, Yoshiyuki Takaishi, Atsushi Arai, Naoto Nakamura, Yusuke Ikeuchi, Masahiro Nakahara, Shigeru Miyake, Hirotoshi Hamaguchi, Eiji Kohmura
The benefits of mechanical thrombectomy(MT)for acute M2 occlusion have remained unclear because of unavoidable device-related complications due to vascular morphological characteristics. We developed a Penumbra-assisted half-stent thrombectomy for achieving secure retrieval of thrombus with minimal damage to the small-caliber vessel. In total, 6 patients were treated with MT for acute M2 occlusion using this technique between November 2016 and May 2017, including 3 men and 3 women, mean age 74.8(51-98)years...
January 2019: No Shinkei Geka. Neurological Surgery
Jay P Kinariwala, Gary B Rajah, Ali W Luqman
Solitaire FR device is a Food and Drug Administration-approved device for mechanical thrombectomy. It has been tested in various clinical trials for its safety and efficacy. We report a case of inadvertent detachment of the Solitaire FR device at stent-stent wire interface while performing mechanical thrombectomy. We review a rare phenomenon of retained Solitaire FR stent retriever in situ and discuss technique of avoidance and its management.
October 2018: Brain Circulation
Osama O Zaidat, Diogo C Haussen, Ameer E Hassan, Ashutosh P Jadhav, Brijesh P Mehta, Maxim Mokin, Nils H Mueller-Kronast, Michael T Froehler
Background and Purpose- The safety and efficacy of mechanical thrombectomy in patients with acute ischemic stroke has been demonstrated. However, the impact of stent retriever size on clinical and angiographic outcomes is not well established. Methods- This was a retrospective ad hoc analysis of data from the STRATIS (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke) registry-a prospective, multicenter study of patients with large vessel occlusion treated with the Solitaire stent retriever...
January 10, 2019: Stroke; a Journal of Cerebral Circulation
Yueqi Zhu, Hongbo Zhang, Yiran Zhang, Huayin Wu, Liming Wei, Gen Zhou, Yuezhou Zhang, Lianfu Deng, Yingsheng Cheng, Minghua Li, Hélder A Santos, Wenguo Cui
Cerebrovascular disease involves various medical disorders that obstruct brain blood vessels or deteriorate cerebral circulation, resulting in ischemic or hemorrhagic stroke. Nowadays, platinum coils with or without biological modification have become routine embolization devices to reduce the risk of cerebral aneurysm bleeding. Additionally, many intracranial stents, flow diverters, and stent retrievers have been invented with uniquely designed structures. To accelerate the translation of these devices into clinical usage, an in-depth understanding of the mechanical and material performance of these metal-based devices is critical...
December 27, 2018: Advanced Materials
Juliane Goebel, Elena Stenzel, Isabel Wanke, Daniel Paech, Martin Koehrmann, Christoph Kleinschnitz, Michael Forsting, Alexander Radbruch, Christoph Moenninghoff
RATIONALE AND OBJECTIVES: Mechanical thrombectomy is common practice in proximal anterior vessel occlusion. However, it remains unclear whether peripheral artery occlusions should be treated as well. This retrospective study aimed to prove the effectiveness of endovascular recanalization treatment for the M2 segment by comparison of intracranial internal carotid artery (ICA), M1 segment, and M2 segment thrombectomy. MATERIALS AND METHODS: All patients who received endovascular treatment for distal ICA, M1, or M2 segment occlusions between January 2010 and July 2017 at our center were re-analyzed with respect to reperfusion success, interventional and clinical parameters...
December 24, 2018: Academic Radiology
Andrew Holden, Andrew Hill, Andrew Walker, Brendan Buckley, Stephen Merrilees, Przemysław Nowakowski, Marek Krzanowski, Marianne Brodmann
PURPOSE: To evaluate the safety and efficacy of the Serranator Alto PTA Serration Balloon Catheter in subjects with peripheral artery disease in the superficial femoral and popliteal arteries. MATERIALS AND METHODS: A prospective, multicenter, single-arm feasibility study enrolled 25 patients (mean age 66 years; 18 men) to evaluate Serranator inflation and postinflation effects under monitoring by independent core laboratories. Inclusion criteria were claudication or ischemic rest pain, de novo lesions or native artery restenosis, >70% stenosis, lesion length <10 cm, and a reference vessel diameter of 4 to 6 mm...
December 24, 2018: Journal of Endovascular Therapy
Brian M Corliss, Kaitlyn F Barkley, Adam J Polifka, Brian L Hoh, W Chris Fox
BACKGROUND: Wide-necked intracranial aneurysms continue to pose a challenge for endovascular surgeons. Flow-diversion and stent-assisted coiling are two techniques that have improved the ability to manage these lesions, but these require the use of dual antiplatelet therapy (DAPT). In patients with aneurysmal subarachnoid hemorrhage, DAPT is relatively contraindicated, and therefore many surgeons prefer to use open techniques or balloon assistance for coiling although there are times when the latter is not feasible...
December 19, 2018: World Neurosurgery
Heinrich P Mattle, Carl Scarrott, Mairsil Claffey, John Thornton, Juan Macho, Christian Riedel, Michael Söderman, Alain Bonafé, Michel Piotin, John Newell, Tommy Andersson
BACKGROUND AND PURPOSE: The goal of the analysis of revascularisation in ischaemic stroke with EmboTrap study (ARISE I) was to demonstrate the effectiveness of EmboTrap. METHODS: ARISE I was an open label, single arm, multicentre, prospective study for the treatment of acute stroke due to large vessel occlusion. The primary outcome was revascularisation of the target vessel as measured by the modified thrombolysis in cerebrovascular infarction (mTICI) score of at least 2b following thrombectomy with EmboTrap...
December 18, 2018: Interventional Neuroradiology
Mandy J Binning, Bruno Bartolini, Blaise Baxter, Ronald Budzik, Joey English, Rishi Gupta, Hirad Hedayat, Antonin Krajina, David Liebeskind, Raul G Nogueira, Ryan Shields, Erol Veznedaroglu
Background Recent randomized controlled trials show benefit of thrombectomy for large vessel occlusion in stroke. Real-world data aid in assessing reproducibility of outcomes outside of clinical trials. The Trevo Retriever Registry is a multicenter, international, prospective study designed to assess outcomes in a large cohort of patients. Methods and Results The Trevo Registry is a prospective database of patients with large vessel occlusion treated with the Trevo device as the first device. The primary end point is revascularization based on modified Thrombolysis in Cerebral Infarction score and secondary end points include 90-day modified Rankin Scale, 90-day mortality, neurological deterioration at 24 hours, and device/procedure related adverse events...
December 18, 2018: Journal of the American Heart Association
Junpei Koge, Seiya Kato, Tetsuya Hashimoto, Yukihiko Nakamura, Masakazu Kawajiri, Takeshi Yamada
BACKGROUND: There is increasing experimental evidence that stent retriever thrombectomy (SRT) may cause arterial wall damage, although histopathological findings focused on vessel wall injury after SRT have not fully been reported in humans. CASE DESCRIPTION: We describe an autopsy case of an 82-year-old woman who presented with acute left intracranial internal carotid artery (ICA) occlusion and received SRT. When we attempted to catheterize the M1 segment of the normal middle cerebral artery (MCA), we were not aware of a duplicated MCA, and the microcatheter was advanced into the main MCA trunk with a smaller caliber than that of the normal M1 segment...
December 6, 2018: World Neurosurgery
Yadong Shi, Jianping Gu, Liang Chen, Wanyin Shi, Mohammed Jameeluddin Ahmed, Hao Huang, Haobo Su
PURPOSE: To review preliminary efficacy and safety outcomes of mechanical thrombectomy using the Solitaire AB device combined with thromboaspiration for treatment of acute embolic occlusion of the superior mesenteric artery (SMA). MATERIALS AND METHODS: Between October 2015 and October 2017, 9 patients (average age, 77 y; range, 62-84 y) presenting with acute mesenteric ischemia attributable to embolic occlusion at the stem of the SMA were retrospectively evaluated for mechanical thrombectomy using the Solitaire AB device combined with manual thromboaspiration...
December 6, 2018: Journal of Vascular and Interventional Radiology: JVIR
Nasreddine Nouri, Marc Ferrigno, Thomas Personnic, Fouzi Bala, Martin Bretzner, Laurent Estrade, Jean-Pierre Pruvo, Hilde Henon, Apolline Kazemi, Nicolas Bricout
BACKGROUND: We aimed to study the safety and performance of real-world thrombectomy using the Sofia catheter in our comprehensive stroke center. METHODS: We conducted a cohort study from a prospective clinical registry of consecutive stroke patients treated by mechanical thrombectomy (MT) between March 2016 and September 2017. Baselines clinical and imaging characteristics, recanalization rates, complications and clinical outcomes were analyzed. RESULTS: Among the 140 patients included, 54 were treated using aspiration first, 64 were treated using aspiration and stent-retriever straightaway and 22 were treated with Sofia as a rescue device...
November 14, 2018: World Neurosurgery
Gianni Boris Bradac, Fabrizio Venturi, Giovanni Bosco, Domenica Garabello, Mario Coriasco, Guido Stura, Giancarlo Ventilii, Mauro Bergui, Paolo Cerrato
PURPOSE: The acute distal intracranial occlusion of the internal carotid artery (ICA) is a very complex heterogeneous pathology, characterized by various patterns. Aim of this work is to identify the different types and propose a classification. METHODS: Among the patients admitted for stroke in the anterior circulation from august 2014 to October 2017, 46 (25%) presented with intracranial distal carotid artery occlusion. The mean age of the patients was 71 (SD 13...
November 13, 2018: Clinical Neuroradiology
Ali Alawieh, A Rano Chatterjee, Jan Vargas, M Imran Chaudry, Jonathan Lena, Raymond Turner, Aquilla Turk, Alejandro Spiotta
BACKGROUND: Endovascular thrombectomy is currently the standard of care for acute ischemic stroke (AIS). Although earlier trials on endovascular thrombectomy were performed using stent retrievers, recently completed the contact aspiration vs stent retriever for successful revascularization (ASTER) and a comparison of direct aspiration versus stent retriever as a first approach (COMPASS) trials have shown the noninferiority of direct aspiration. OBJECTIVE: To report the largest experience with ADAPT thrombectomy and compare the impact of advancement in reperfusion catheter technologies on outcomes...
November 10, 2018: Neurosurgery
Simone Peschillo, Alejandro Tomasello, Francesco Diana, David Hernandez, Giada Toccaceli, Marta Rosal-Fontana, Marielle Esteves Coelho, Paolo Missori
Objectives: To assess the delayed (15 days) histological and ultrastructural changes occurring following endovascular treatment with a direct aspiration first pass technique (ADAPT) or stent retrievers (SRs) and to compare the findings in order to determine which is the least harmful technique and what changes occur. Materials and Methods: Damage to the wall of swine extracranial arteries was evaluated after ADAPT with the Penumbra system or thrombectomy with various SRs...
October 2018: Interventional Neurology
Mohamed S Teleb
Background: Treatment of large vessel occlusion acute ischemic stroke with mechanical thrombectomy has become the standard of care after recent clinical trials. However, the degree of recanalization with stent retrievers remains very important in overall outcomes. We sought to review the utility of a new balloon guide catheter (BGC) in improving the degree of recanalization in conjunction with mechanical thrombectomy. Methods: The medical records of a prospectively collected endovascular ischemic stroke database were reviewed...
October 2018: Interventional Neurology
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