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Stent retriever device

Naoko Funatsu, Mikito Hayakawa, Tetsuya Hashimoto, Hiroshi Yamagami, Tetsu Satow, Jun C Takahashi, Masatoshi Koga, Kazuyuki Nagatsuka, Hatsue Ishibashi-Ueda, Toru Iwama, Kazunori Toyoda
BACKGROUND AND PURPOSE: Vascular wall components (VWCs) are sometimes identified as collagen fibers in specimens retrieved by thrombectomy from acute stroke patients. However, their clinical significance and associated factors remain unclear. The purpose of this study was to clarify the factors associated with VWCs in retrieved thrombi. METHODS: Consecutive acute stroke patients treated endovascularly using the Penumbra aspiration catheter or stent retrievers (SRs) at our institute from November 2013 to April 2016 were retrospectively reviewed, and the retrieved thrombi were evaluated histopathologically...
August 10, 2018: Journal of Neurointerventional Surgery
Yongtao Guo, Wenjie Zi, Yue Wan, Shuai Zhang, Bo Sun, Xianjin Shang, Shun Li, Yongjie Bai, Zibao Li, Dequan Zheng, Xinfeng Liu
BACKGROUND AND PURPOSE: The aim of the study was to evaluate whether leukoaraiosis severity is associated with outcome in acute stroke patients undergoing mechanical thrombectomy with stent-retriever devices. METHODS: In this retrospective multicenter study, we evaluated 251 acute stroke patients (pretreatment National Institutes of Health Stroke Scale score ≥8) treated with stent-retriever devices. Leukoaraiosis severity was graded as 0-2 (absent-to-moderate) versus 3-4 (severe) according to the van Swieten scale...
July 24, 2018: Journal of Neurointerventional Surgery
Monika Müller-Eschner, Se-Jong You, Kolja Jahnke, Sara Kammerer, Christian Foerch, Waltraud Pfeilschifter, Arne Lauer, Joachim Berkefeld, Marlies Wagner
BACKGROUND AND PURPOSE: To describe our first experience using a small stent retriever specifically designed for thrombectomy in cerebral arteries with a small caliber (Acandis APERIO® 3.5/28) in patients with acute ischemic stroke. MATERIALS AND METHODS: All patients with an acute ischemic stroke, who underwent endovascular recanalization using the APERIO® thrombectomy device with a diameter of 3.5 mm, were identified in retrospect and included in the present analysis...
July 23, 2018: Cardiovascular and Interventional Radiology
Osama O Zaidat, Alicia C Castonguay, Rishi Gupta, Chung-Huan J Sun, Coleman Martin, William E Holloway, Nils Mueller-Kronast, Joey D English, Italo Linfante, Guilherme Dabus, Tim W Malisch, Franklin A Marden, Hormozd Bozorgchami, Andrew Xavier, Ansaar T Rai, Michael T Froehler, Aamir Badruddin, Thanh N Nguyen, M Asif Taqi, Michael G Abraham, Vallabh Janardhan, Hashem Shaltoni, Roberta Novakovic, Albert J Yoo, Alex Abou-Chebl, Peng R Chen, Gavin W Britz, Ritesh Kaushal, Ashish Nanda, Mohammad A Issa, Raul G Nogueira
BACKGROUND: Limited post-marketing data exist on the use of the Solitaire FR device in clinical practice. The North American Solitaire Stent Retriever Acute Stroke (NASA) registry aimed to assess the real world performance of the Solitaire FR device in contrast with the results from the SWIFT (Solitaire with the Intention for Thrombectomy) and TREVO 2 (Trevo versus Merci retrievers for thrombectomy revascularization of large vessel occlusions in acute ischemic stroke) trials. METHODS: The investigator initiated NASA registry recruited North American sites to submit retrospective angiographic and clinical outcome data on consecutive acute ischemic stroke (AIS) patients treated with the Solitaire FR between March 2012 and February 2013...
July 2018: Journal of Neurointerventional Surgery
Aquilla S Turk, Alex Spiotta, Don Frei, J Mocco, Blaise Baxter, David Fiorella, Adnan Siddiqui, Maxim Mokin, Michael Dewan, Henry Woo, Raymond Turner, Harris Hawk, Amrendra Miranpuri, Imran Chaudry
BACKGROUND: The development of new revascularization devices has improved recanalization rates and time but not clinical outcomes. We report our initial results with a new technique utilizing a direct aspiration first pass technique with a large bore aspiration catheter as the primary method for vessel recanalization. METHODS: A retrospective evaluation of a prospectively captured database of 37 patients at six institutions was performed on patients where the ADAPT technique was utilized...
July 2018: Journal of Neurointerventional Surgery
Aquilla S Turk, Don Frei, David Fiorella, J Mocco, Blaise Baxter, Adnan Siddiqui, Alex Spiotta, Maxim Mokin, Michael Dewan, Steve Quarfordt, Holly Battenhouse, Raymond Turner, Imran Chaudry
BACKGROUND: The development of new revascularization devices has improved recanalization rates and time, but not clinical outcomes. We report a prospectively collected clinical experience with a new technique utilizing a direct aspiration first pass technique with large bore aspiration catheter as the primary method for vessel recanalization. METHODS: 98 prospectively identified acute ischemic stroke patients with 100 occluded large cerebral vessels at six institutions were included in the study...
July 2018: Journal of Neurointerventional Surgery
Taishi Hirai, Jonathan Rosenberg, Sandeep Nathan, John E A Blair
A 68-year-old female with a history of coronary artery disease and prior bypass surgery presented for staged percutaneous coronary intervention (PCI) to a calcified and angulated ostial left circumflex (LCX) artery lesion after PCI of the anastomosis of the left internal mammary artery - to left anterior descending artery. Orbital atherectomy of the LCX was performed at a speed of 80,000 RPM with multiple passes, and was complicated by device microtip dislodgement and entrapment within the vessel. After advancing a "buddy" wire beyond the microtip, a tapered microcatheter was advanced over the ViperWire and into the edge of the broken microtip and torqued into the microtip with forward pressure using the 0...
July 18, 2018: Catheterization and Cardiovascular Interventions
Mersedeh Bahr Hosseini, Graham Woolf, Latisha K Sharma, Jason D Hinman, Neal M Rao, Bryan Yoo, Reza Jahan, Sidney Starkman, May Nour, Radoslav Raychev, David S Liebeskind, Jeffrey L Saver
BACKGROUND AND PURPOSE: Endovascular therapy (ET) has become the standard of care for selected patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO). However, many LVO or medium vessel occlusion (MVO) patients are ineligible for ET, including some who harbor salvageable tissues. To develop complementary therapies for these patients, it is important to delineate their prevalence, clinical features, and outcomes. METHODS: In a prospectively maintained database, we reviewed consecutive AIS patients between December 2015 and September 2016...
July 16, 2018: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
Paul Page, David Niemann, Colin Son, Yiping Li
Background: Neuroendovascular techniques have significantly altered the treatment paradigm of cerebrovascular diseases. Since the introduction of distal cerebral protection devices (DCPD), the incidence of embolic strokes during carotid artery stenting (CAS) has been significantly reduced. Treatment guidelines for retained foreign bodies in the cerebral vasculature do not exist. Case Description: Here, we present the case of an 88-year-old male who, during carotid artery angioplasty and stenting for symptomatic carotid artery stenosis, suffered from a retained distal protection device ultimately requiring open surgical carotid endarterectomy including removal of the retained device and stent...
2018: Surgical Neurology International
Alexander Massmann, Peter Fries, Reinhard Kubale, Roland Seidel
AIMS: Ultrasound of a 59-year-old patient presenting signs of congestive heart failure and abdominal pain depicted cirrhose-cardiaque based on volume-overload related right-heart-insufficiency. Computed-tomography revealed an underlying abdominal aortic aneurysm of maximum 7.5cm combined with a large aorto-caval fistula (ACF) to the infrarenal vena cava (IVC). METHODS AND RESULTS: After urgent EVAR a large endoleak type 2 (EL2) and ACF persisted. Coil-embolization of inferior mesenteric artery was performed...
July 3, 2018: EuroIntervention
L O'Connell, M P Broe, D Rooney, S Elhag, I Cheema, B B McGuire
Ureteric stents are frequently inserted post endourological procedures. However, subsequent endoscopic stent removal requires a second procedure for the patient and the availability of necessary resources. Longer duration of indwelling stents can lead to increased risk of symptoms and complications. The use of magnetic stents removed with a magnetic retrieval device (BlackStar©), offers an alternative which obviates the need for cystoscopy. We assessed the outcomes for this novel method of stent removal in our institution...
February 9, 2018: Irish Medical Journal
Anouchska S A Autar, Hajo M Hund, Sharad A Ramlal, Daniël Hansen, Geert J Lycklama À Nijeholt, Bart J Emmer, Moniek P M de Maat, Diederik W J Dippel, Aad van der Lugt, Adriaan C G M van Es, Heleen M M van Beusekom
BACKGROUND: Currently, acute ischemic stroke is still a leading cause of mortality and morbidity. Approximately 2 years ago, mechanical thrombectomy was proven beneficial as a revolutionary new therapy for stroke in the MR-CLEAN trial (A Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands). However, the mechanisms by which the thrombectomy device, or stent-retriever, interacts with the thrombus are largely unknown. A better understanding could lead to improved efficacy of mechanical thrombectomy devices...
June 22, 2018: Journal of the American Heart Association
Perry P Ng, Theodore C Larson, Christopher W Nichols, Mark M Murray, Karen L Salzman, Richard H Smith
BACKGROUND: Stent retriever thrombectomy (SRT) in acute thromboembolic stroke can result in post-thrombectomy subarachnoid hemorrhage (PTSAH). Intraprocedural findings associated with PTSAH are not well defined. OBJECTIVE: To identify angiographic findings and procedural factors during SRT that are associated with PTSAH. MATERIALS AND METHODS: This was a retrospective, observational cohort study of consecutive patients with middle cerebral artery (MCA) acute ischemic stroke treated with SRT...
June 21, 2018: Journal of Neurointerventional Surgery
Sergio Nappini, Nicola Limbucci, Giuseppe Leone, Andrea Rosi, Leonardo Renieri, Arturo Consoli, Antonio Laiso, Iacopo Valente, Francesco Rosella, Riccardo Rosati, Salvatore Mangiafico
BACKGROUND: Recent trials established the efficacy of mechanical stent-retriever thrombectomy for treatment of stroke patients with large vessel occlusion (LVO) in the anterior circulation. However, stent-retriever thrombectomy may not accomplish successful recanalization in all patients. The aim of this study is to report the role of bail-out permanent stenting after failure of mechanical thrombectomy. METHODS: Among 430 patients included in a prospectively maintained database, we analysed 325 cases of anterior circulation LVO...
June 18, 2018: Journal of Neuroradiology. Journal de Neuroradiologie
Naomi Larsen, Katharina Oberbeck, Rodrigo Lima de Miranda, Jens Trentmann, Jawid Madjidyar, Eckhard Quandt, Olav Jansen
PURPOSE:  Various stent retrievers differing in stent design and mechanical properties are currently available for the treatment of ischemic stroke. We conducted this in vitro study to compare the efficacy, embolism rate, and safety of commercially available stent retrievers and prototypes. MATERIALS AND METHODS:  Whole blood thrombi were produced in a Chandler loop. The thrombi were inserted into the curved M1 segment of a silicone model of the anterior cerebral circulation...
June 18, 2018: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
James C Meek, Jonathan S McDougal, Daniel Borja-Cacho, Mary E Meek
Hepatic artery thrombosis (HAT) is a major cause of morbidity and mortality after orthotopic liver transplantation, occurring in 5% of cases (Piardi et al, 2016). HAT is the second main cause of graft loss after primary nonfunction, the leading cause of graft failure in the immediate postoperative period (<1 month), and is associated with a mortality rate of up to 60% without intervention (Piardi et al, 2016; Pareja et al., 2010; Crossin et al., 2003). Although retransplantation is the preferred therapy, the limited availability of donor organs can necessitate urgent, alternative treatment...
April 2018: Radiology Case Reports
Zeferino Demartini Junior, Luana A Maranha Gatto, Gelson Luis Koppe, Tatiana F von Hertwig de Oliveira, Alexandre Novicki Francisco
Thromboembolism is the most frequent complication in endovascular treatment of intracranial aneurysms, causing disability and death. As stent retrievers have achieved high rates of arterial recanalization in the management of ischemic stroke, these devices were tested as rescue therapy of thromboembolism during aneurysm embolization. We retrospectively analyzed 10 consecutive patients with transprocedural arterial occlusion, treated with mechanical thrombectomy at a single center. Good angiographic recanalization was achieved in eight cases, mTICI 3, 2b and 2a in five, three and two patients, respectively, without additional complications or any deaths...
May 2018: Arquivos de Neuro-psiquiatria
Matteo Ruggeri, Michele Basile, Andrea Zini, Salvatore Mangiafico, Elio Clemente Agostoni, Kyriakos Lobotesis, Jeffrey Saver, Silvia Coretti, Carlo Drago, Americo Cicchetti
BACKGROUND: Stroke has a significant disease burden in terms of acute and long-term disability in Italy and throughout the world. Endovascular treatments for the management of a stroke event have been coupled in the past years with the possibility to mechanically remove the occlusion by means of specially designed thrombectomy devices, and their exclusive use showed levels of effectiveness in line with those of the existing pharmacological treatments. OBJECTIVE: To assess the cost-effectiveness of mechanical thrombectomy (MT) with the Solitaire Revascularization Device (stent retriever) for the treatment of acute ischemic stroke (AIS) in patients with large vessel occlusions (LVOs), comparing MT plus intravenous tissue plasminogen activation (MT plus IV t-PA) vs IV t-PA alone, in Italy...
June 28, 2018: Journal of Medical Economics
Diogo C Haussen, Alhamza R Al-Bayati, Jonathan A Grossberg, Mehdi Bouslama, Clara Barreira, Nicolas Bianchi, Michael R Frankel, Raul G Nogueira
BACKGROUND: Longer stent retrievers have recently become available and have theoretical advantages over their shorter counterparts. We aim to evaluate whether stent retriever length impacts reperfusion rates in stroke thrombectomy. METHODS: This was a retrospective analysis of a prospectively collected thrombectomy database in which equal diameter (4 mm) stent retrievers were used as the first-line strategy for intracranial internal carotid or middle cerebral artery M1 or M2 occlusions along with a balloon guide catheter from June 2011 to March 2017...
June 1, 2018: Journal of Neurointerventional Surgery
Philipp Gruber, Salome Zeller, Carlos Garcia-Esperon, Jatta Berberat, Javier Anon, Michael Diepers, Krassen Nedeltchev, Fabian Flottmann, Jens Fiehler, Luca Remonda, Timo Kahles
BACKGROUND AND PURPOSE: Given the promising performance of the new Embolus Retriever with Interlinked Cages (ERIC) in smaller case series, we sought to assess the efficacy and safety of mechanical thrombectomy (MT) with ERIC compared with other stent retrievers (SRs) in acute ischemic stroke due to large vessel occlusion (LVO). METHODS: We reviewed the databases of two comprehensive stroke centers in in Germany and Switzerland for MT due to LVO in the anterior circulation with either ERIC or another SR as a first device...
May 17, 2018: Journal of Neurointerventional Surgery
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