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Stent retriever device

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)...
October 18, 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, Sourour Nader-Antoine, 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
Victor Chien-Chia Wu, Tien-Hsing Chen, Michael Wu, Shao-Wei Chen, Chih-Hsiang Chang, Chun-Wei Chang, Ching-Chang Chen, Katie Pei-Hsuan Wu, Ming-Jer Hsieh, Chao-Yung Wang, Shang-Hung Chang, Fen-Chiung Lin, I-Chang Hsieh, Pao-Hsien Chu, Ming-Shien Wen
OBJECTIVES: Hypertrophic cardiomyopathy (HCM) entails thickening of the myocardium and an increased risk of ischaemia. However, the prognosis of patients with HCM with acute myocardial infarction (AMI) is incompletely understood. METHODS: Medical information was retrieved from the Taiwan National Health Insurance Research Database in 1997-2011. The exclusion criteria were patients <18 years old, and history of AMI, coronary intervention, aortic valve disease, disease of the pericardium, heart surgery, device implantation, venous thromboembolism, cardiac transplant, congenital heart disease and end-stage renal disease on dialysis...
August 23, 2018: BMJ Open
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...
September 1, 2018: Catheterization and Cardiovascular Interventions
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