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Stent retriever device

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
Hyun-Nyung Lee, Bum-Tea Kim, Soo-Bin Im, Sun-Chul Hwang, Je-Hoon Jeong, Moon-Young Chung, Jong-Hyun Park, Dong-Seong Shin
Objective: Protocols for posterior circulation ischemic stroke have not been established by randomized clinical trials. Mechanical endovascular thrombectomy (MET) devices are evolving, and many of these devices already developed or in development are suitable for posterior circulation MET. Materials and Methods: We investigated the medical records of patients who underwent MET for posterior circulation ischemic stroke from January 2012 to August 2016. Fifteen patients were included...
September 2018: Journal of Cerebrovascular and Endovascular Neurosurgery
Nicholas Isom, Reza Masoomi, Axel Thors, Matthew Bunte, Anand Prasad, Kirk Hance, Kamal Gupta
BACKGROUND/OBJECTIVES: Orbital atherectomy (OA) is routinely being used for plaque modification to facilitate percutaneous revascularization in patients with peripheral arterial disease (PAD) and arterial calcification. Guidewire fracture (GWF) during OA, though anecdotally described, has not been studied in a systematic manner. We conducted a review of the Manufacturer and User Facility Device Experience (MAUDE) database to study the reports of wire fracture and its management and consequences...
November 1, 2018: Catheterization and Cardiovascular Interventions
Florent Gariel, Bertrand Lapergue, Romain Bourcier, Jérôme Berge, Xavier Barreau, Mikael Mazighi, Maéva Kyheng, Julien Labreuche, Robert Fahed, Raphael Blanc, Benjamin Gory, Alain Duhamel, Suzana Saleme, Vincent Costalat, Serge Bracard, Hubert Desal, Lili Detraz, Arturo Consoli, Michel Piotin, Gaultier Marnat
Background and Purpose- Intravenous thrombolysis (IVT) within 4.5 hours of symptom onset is currently recommended before mechanical thrombectomy (MT). We compared functional outcome, neurological recovery, reperfusion, and adverse events according to the use or not of IVT before MT. Methods- This is a post hoc analysis of the ASTER trial (Contact Aspiration Versus Stent Retriever for Successful Revascularization). The primary outcome was favorable 90-day functional outcome defined as a modified Rankin Scale of ≤2...
October 2018: Stroke; a Journal of Cerebral Circulation
C O A Tsang, I H W Cheung, K K Lau, W Brinjikji, D F Kallmes, T Krings
BACKGROUND: There is ongoing debate regarding the optimal first-line thrombectomy technique for large-vessel occlusion. PURPOSE: We performed a systematic review and meta-analysis of comparative studies on stent retriever-first and aspiration-first thrombectomy. DATA SOURCES: We searched Ovid MEDLINE, PubMed, and EMBASE from 2009 to February 2018. STUDY SELECTION: Two reviewers independently selected the studies. The primary end point was successful reperfusion (TICI 2b/3)...
November 2018: AJNR. American Journal of Neuroradiology
Kevin Li-Chun Hsieh, Kai-I Chuang, Hsu-Huei Weng, Sho-Jen Cheng, Yu Chiang, Cheng-Yu Chen
Background: Recent trials have proved the efficacy of mechanical thrombectomy over medical treatment for patients with acute ischemic stroke, with the balance of equivalent rates of adverse events. Stent retrievers were applied predominantly in most trials; however, the role of other thrombectomy devices has not been well validated. A direct aspiration first-pass technique (ADAPT) is proposed to be a faster thrombectomy technique than the stent retriever technique. This meta-analysis investigated and compared the efficacy and adverse events of first-line ADAPT with those of first-line stent retrievers in patients with acute ischemic stroke...
2018: Frontiers in Neurology
David Fiorella, Alan Boulos, Aquilla S Turk, Adnan H Siddiqui, Adam S Arthur, Orlando Diaz, Demetrius K Lopes
INTRODUCTION: The LVIS stent system (LVIS and LVIS Junior) is a self-expanding, retrievable, microstent system indicated for the treatment of wide-necked cerebral aneurysms (WNAs). The present pivotal study was performed to evaluate the safety and effectiveness of this device. METHODS: The US LVIS pivotal trial was a prospective, multicenter, single-arm, interventional study conducted at 21 US centers. The study enrolled 153 adults with WNAs of the anterior and posterior circulations...
October 8, 2018: Journal of Neurointerventional Surgery
Wen-Jung Chung, Yasuaki Takeji, Yoshimitsu Soga, Kenji Ando
A 64-year-old man with a history of right external iliac artery stenosis after stenting with a self-expandable stent was admitted for repetitive in-stent restenosis (ISR). To treat ISR, we selected a balloon expandable stent (BES) that was prepared with negative suction before being inserted into the sheath. BES dislodged when the stent balloon was incompletely inflated and was simultaneously deformed in a funnel shape. When BES was retrieved using a short noncompliant balloon, it dislodged again because of an imbalanced proximal inflation of the balloon...
January 2018: Journal of Cardiology Cases
Tomotaka Ohshima, Reo Kawaguchi, Yoshitaka Nagano, Shigeru Miyachi, Naoki Matsuo, Masakazu Takayasu
BACKGROUND: Stent clot retrievers (SRs) can be used to perform mechanical thrombectomy for the treatment of acute major arterial occlusion. Recanalization is faster and outcomes are better with treatment involving these devices than with internal treatment. Although several SRs are available, their clot-capturing abilities are unclear. Therefore, in the present study, we numerically evaluated the clot-capturing abilities of SRs in an experimental vascular model. METHODS: A sham clot (urethane foam) was fixed with sutures at the middle of a vascular model (polyvinyl chloride tube)...
September 25, 2018: World Neurosurgery
Luis San Román, Bijoy K Menon, Jordi Blasco, María Hernández-Pérez, Antoni Dávalos, Charles B L M Majoie, Bruce C V Campbell, Francis Guillemin, Hester Lingsma, René Anxionnat, Jonathan Epstein, Jeffrey L Saver, Henk Marquering, John H Wong, Demetrius Lopes, Gernot Reimann, Hubert Desal, Diederik W J Dippel, Shelagh Coutts, Richard du Mesnil de Rochemont, Dileep Yavagal, Jean Christophe Ferre, Yvo B W E M Roos, David S Liebeskind, Robert Lenthall, Carlos Molina, Fahad S Al Ajlan, Vivek Reddy, Dar Dowlatshahi, Nader-Antoine Sourour, Catherine Oppenheim, Alim P Mitha, Stephen M Davis, Christian Weimar, Robert J van Oostenbrugge, Erik Cobo, Timothy J Kleinig, Geoffrey A Donnan, Aad van der Lugt, Andrew M Demchuk, Olvert A Berkhemer, Anna M M Boers, Gary A Ford, Keith W Muir, B Scott Brown, Tudor Jovin, Wim H van Zwam, Peter J Mitchell, Michael D Hill, Phil White, Serge Bracard, Mayank Goyal
BACKGROUND: Evidence regarding whether imaging can be used effectively to select patients for endovascular thrombectomy (EVT) is scarce. We aimed to investigate the association between baseline imaging features and safety and efficacy of EVT in acute ischaemic stroke caused by anterior large-vessel occlusion. METHODS: In this meta-analysis of individual patient-level data, the HERMES collaboration identified in PubMed seven randomised trials in endovascular stroke that compared EVT with standard medical therapy, published between Jan 1, 2010, and Oct 31, 2017...
October 2018: Lancet Neurology
Batuhan Kara, Hatem Hakan Selcuk, Aysun Erbahceci Salik, Hasanagha Zalov, Omer Yildiz, Gunay Gul, Bedih Balkan
BACKGROUND: Tigertriever (Rapid Medical, Yoqneam, Israel) is a new design of stent retriever. PURPOSE: To evaluate the feasibility, safety, and efficacy of the Tigertriever in patients with acute ischemic stroke who have undergone mechanical thrombectomy. MATERIALS AND METHODS: Two different techniques-namely, standard unsheathing (SUT) and repetitive inflation-deflation (RID) techniques, were used. Modified Thrombolysis in Cerebral Infarction (mTICI) scores of 2b and 3 were considered as successful recanalization...
September 27, 2018: Journal of Neurointerventional Surgery
Guillaume Gravel, Grégoire Boulouis, Wagih Benhassen, Christine Rodriguez-Regent, Denis Trystram, Myriam Edjlali-Goujon, Jean-François Meder, Catherine Oppenheim, Serge Bracard, Waleed Brinjikji, Olivier N Naggara
OBJECTIVE: Our aim was to compare the clinical outcome of patients with ischaemic stroke with anterior large vessel occlusion treated with stent retrievers and/or contact aspiration mechanical thrombectomy (MT) under general anaesthesia (GA) or conscious sedation non-GA through a systematic review and meta-analysis. METHODS: The literature was searched using PubMed, Embase and Cochrane databases to identify studies reporting on anaesthesia and MT. Using fixed or random weighted effect, we evaluated the following outcomes: 3-month mortality, modified Rankin Score (mRs) 0-2, recanalisation success (thrombolysis in cerebral infarction (TICI) ≥2b) and symptomatic intracerebral haemorrhagic (sICH) transformation...
September 26, 2018: Journal of Neurology, Neurosurgery, and Psychiatry
Maxim Mokin, Alex Abou-Chebl, Alicia C Castonguay, Raul G Nogueira, Joey D English, Hamed Farid, Rishi Gupta, Coleman Martin, William Edward Holloway, Diogo C Haussen, Nils Mueller-Kronast, Osama O Zaidat
BACKGROUND: The DEFUSE 3 and DAWN trials have shown the benefit of thrombectomy beyond 6 hours of stroke symptom onset in carefully selected patients. OBJECTIVE: To evaluate the real-world outcomes of stent retriever thrombectomy beyond 6 hours of stroke onset using combined individual patient data from the North American Solitaire Stent Retriever Acute Stroke (NASA) and Trevo Stent-Retriever Acute Stroke (TRACK) registries. METHODS: Pooled analysis of individual patient data of all cases of anterior circulation acute ischemic stroke (AIS) from NASA and TRACK was performed to compare outcomes of patients presenting within the first hours 6 or beyond 6 hours of stroke symptom onset...
September 15, 2018: Journal of Neurointerventional Surgery
Lingyun Zhang, Yugang Jiang
The present study aimed to evaluate the operation, application and safety of a novel prototype device designed for the retrieval of a migrated coils, an intraprocedural complication of endovascular aneurysm treatment, compared with the widely used Solitaire AB stent retriever. The prototype retrieval device, referred to as magnetic wires, consisted of two microwires that were joined by a small magnetic ring near to the tips. To retrieve a coil, the wires are advanced through the dislodged coil one at a time and then capture the target coil in a chopstick-like manner, as their tips are attracted to the magnet...
September 2018: Experimental and Therapeutic Medicine
Johannes A R Pfaff, Ralf Siekmann, Yogesh P Shah, Peter A Ringleb, Christian Ulfert, Kai Koller, Martin Bendszus, Markus A Möhlenbruch
PURPOSE: To report in vivo experience of a delivery assist catheter as ascending aid for a large-bore catheter for intracranial thromboaspiration. METHODS: Retrospective data collection and analysis of stroke databases of two comprehensive stroke centers focusing on technical and angiographic parameters - primary endpoint defined as reaching the occlusion with a large-bore reperfusion catheter - from patients receiving endovascular stroke treatment using an AXS Offset™ delivery assist catheter (Stryker, Fremont, CA, USA) between May 2017 and November 2017...
September 6, 2018: Clinical Neuroradiology
Alberto Tringali, Giulia Bonato, Lorenzo Dioscoridi, Massimiliano Mutignani
Colorectal foreign bodies (FB) are challenging issues for the endoscopist especially if the mostly used methods (polypectomy snare, biopsy forceps or wire-guided 40 mm dilation balloon) failed. We report a case of a 31-year-old man who was admitted in the emergency department for the impaction of a 60 cm long and large-size FB in the sigmoid colon. We failed to remove the FB using several different standard technique because of the rigidity, the smoothness and the size of the object. After all these attempts, we built up a 'home-made' device inserting a 0...
September 1, 2018: BMJ Case Reports
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