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Solitaire device

Jonathan T Caranfa, Elaine Nguyen, Rafay Ali, Iregi Francis, Albert Zichichi, Elliott Bosco, Craig I Coleman, William L Baker, Christine G Kohn
BACKGROUND: Randomized controlled trials (RCTs) have compared mechanical endovascular therapy (MET) in addition to intravenous tissue plasminogen activator (IVtPA) to IVtPA alone for the management of acute ischemic stroke (AIS). Direct comparative studies between individual METs are not available. In lieu of head-to-head randomized control trials, we performed an adjusted indirect treatment comparison (ITC) meta-analysis to assess the comparative efficacy and safety of different METs, Solitaire+IVtPA and Penumbra+IVtPA in AIS patients...
2018: PloS One
Osama O Zaidat, Alicia C Castonguay, Italo Linfante, Rishi Gupta, Coleman O Martin, William E Holloway, Nils Mueller-Kronast, Joey D English, 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, Albert J Yoo, Vallabh Janardhan, Hashem Shaltoni, Roberta Novakovic, Alex Abou-Chebl, Peng R Chen, Gavin W Britz, Chung-Huan J Sun, Vibhav Bansal, Ritesh Kaushal, Ashish Nanda, Raul G Nogueira
BACKGROUND AND PURPOSE: In acute ischemic stroke, fast and complete recanalization of the occluded vessel is associated with improved outcomes. We describe a novel measure for newer generation devices: the first pass effect (FPE). FPE is defined as achieving a complete recanalization with a single thrombectomy device pass. METHODS: The North American Solitaire Acute Stroke Registry database was used to identify a FPE subgroup. Their baseline features and clinical outcomes were compared with non-FPE patients...
February 19, 2018: Stroke; a Journal of Cerebral Circulation
Geng Zhou, Ming-Hua Li, Hai-Tao Lu, Jiang-Shan Deng, Yu-Wu Zhao, Yi Xiang J Wang, Yue-Qi Zhu
INTRODUCTION: Mechanical thrombectomy (MT) has been widely accepted as a safe and effective treatment for acute ischemic stroke (AIS). Development of stent retriever devices has been intensively developed over the past two decades. In this study, we compared the effectiveness and safety of a new thrombectomy device with Solitaire FR for the treatment of AIS models. METHODS: Mechanical performance of stent retrievers was tested in vitro. Thrombin-induced thrombus was pre-injected into the right distal external carotid-maxillary artery in 18 dogs to create an acute thrombus occlusion model, and these animals were divided into a Tonbridge group (n=9, with Tonbridge stent Tonbridge Medical Technology) and a Solitaire group as control (n=9, with Solitaire stent, ev3 Neurovascular)...
February 14, 2018: Journal of Neurointerventional Surgery
Sabrina Trippoli, Erminia Caccese, Claudio Marinai, Andrea Messori
OBJECTIVES: In the acute ischemic stroke, endovascular devices have shown promising clinical results and are also likely to represent value for money, as several modeling studies have shown. Pharmacoeconomic evaluations in this field, however, have little impact on the procurement of these devices. The present study explored how complex pharmacoeconomic models that evaluate effectiveness and cost can be incorporated into the in-hospital procurement of thrombectomy devices. PATIENTS AND METHODS: As regards clinical modeling, we extracted outcomes at three months from randomized trials conducted for four thrombectomy devices, and we projected long-term results using standard Markov modeling...
January 29, 2018: Clinical Neurology and Neurosurgery
Young-Jin Kim, Kwang-Wook Cho, Seong-Rim Kim, Do-Sung Yoo, Hae-Kwan Park, Cheol Ji
Objective: Intraarterial thrombolysis (IA-Tx) with stent retriever is accepted as an additional treatment for selected patients and the clinical benefit is well reported. Each intravenous tissue plasminogen activator administration (IV-tPA) and perfusion diffusion mismatching (P/D-mismatching) is well known the beneficial effects for recanalization and clinical outcomes. In this report, authors analyzed the clinical outcomes of additional IA-Tx with retrieval stent device, according to the combined IV-tPA and P/D-mismatching or not...
December 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
Vernard S Fennell, Swetadri Vasan Setlur Nagesh, Karen M Meess, Liza Gutierrez, Rhys H James, Michael E Springer, Adnan H Siddiqui
BACKGROUND: Despite advances in revascularization tools for large vessel occlusion presenting as acute ischemic stroke, a significant subset of clots remain recalcitrant to current strategies. We assessed the effectiveness of a novel thrombectomy device that was specifically designed to retrieve resistant fibrin rich clots, the geometric clot extractor (GCE; Neuravi, Galway, Ireland), in an in vitro cerebrovascular occlusion stroke model. METHODS: After introducing fibrin rich clot analogues into the middle cerebral artery of the model, we compared the rates of recanalization between GCE and Solitaire flow restoration stent retriever (SR; Medtronic, Minneapolis, Minnesota, USA; control group) cases...
January 19, 2018: Journal of Neurointerventional Surgery
Johannes Pfaff, Stefan Rohde, Tobias Engelhorn, Arnd Doerfler, Martin Bendszus, Markus Alfred Möhlenbruch
BACKGROUND AND PURPOSE: The application of radiopaque markers to the Solitaire™ stent-retriever for better visibility during mechanical thrombectomy (MT) has the potential to alter the well-known characteristics of the device; however, it is uncertain whether this adjustment influences efficacy or safety of the enhanced stent-retriever. METHODS: Retrospective analysis of stroke databases of three comprehensive stroke centers. Our investigation was focused on technical and angiographic parameters, including procedure times, reperfusion results (thrombolysis in cerebral infarction, TICI), periprocedural complications and favorable early neurological recovery at discharge (modified Rankin scale ≤2 or National Institutes of Health Stroke Scale, NIHSS = 0 or ∆NIHSS ≥ 10), from consecutive patients with acute anterior circulation ischemic stroke treated with a Solitaire™ Platinum stent-retriever between October 2016 and March 2017...
January 10, 2018: Clinical Neuroradiology
Hamidreza Saber, Gary B Rajah, Riyad Y Kherallah, Ashutosh P Jadhav, Sandra Narayanan
INTRODUCTION: Mechanical thrombectomy (MT) is increasingly used for large-vessel occlusions (LVO), but randomized clinical trial (RCT) level data with regard to differences in clinical outcomes of MT devices are limited. We conducted a network meta-analysis (NMA) that enables comparison of modern MT devices (Trevo, Solitaire, Aspiration) and strategies (stent retriever vs aspiration) across trials. METHODS: Relevant RCTs were identified by a systematic review. The efficacy outcome was 90-day functional independence (modified Rankin Scale (mRS) score 0-2)...
December 15, 2017: Journal of Neurointerventional Surgery
F S Al-Ajlan, A S Al Sultan, P Minhas, Z Assis, M A de Miquel, M Millán, L San Román, A Tomassello, A M Demchuk, T G Jovin, P Cuadras, A Dávalos, M Goyal, B K Menon
BACKGROUND AND PURPOSE: Endovascular therapy has become the standard of care for patients with disabling anterior circulation ischemic stroke due to proximal intracranial thrombi. Our aim was to determine whether the beneficial effect of endovascular treatment on functional outcome could be explained by a reduction in posttreatment infarct volume in the Endovascular Revascularization With Solitaire Device Versus Best Medical Therapy in Anterior Circulation Stroke Within 8 Hours (REVASCAT) trial...
January 2018: AJNR. American Journal of Neuroradiology
Radoslav Raychev, Reza Jahan, Jeffrey L Saver, Raul G Nogueira, Mayank Goyal, Vitor M Pereira, Elad Levy, Dileep R Yavagal, Christophe Cognard, David Liebeskind
Microcatheter contrast injection (MCI) prior to stent retriever deployment for the treatment of acute ischemic stroke may be useful for evaluation of distal anatomy and flow patterns beyond the occlusion. However, prior data from intra-arterialthrombolysis suggested that MCI increases the risk of intracranial hemorrhage (ICH). The safety and utility of MCI has not been investigated in the setting of thrombectomy. METHODS: We analyzed the Solitaire With the Intention For Thrombectomy as Primary Endovascular Treatment (SWIFT PRIME) trial to correlate pre-intervention MCI flow with collateral flow, and to investigate its impact on ICH and clinical outcome after thrombectomy with the Solitaire device...
November 10, 2017: Journal of Neurointerventional Surgery
Ju-Yu Chueh, Miklos G Marosfoi, Olivia W Brooks, Robert M King, Ajit S Puri, Matthew J Gounis
Background: Over the course of the thrombectomy procedure, clot fragments may become dislodged and lead to downstream emboli due to manipulation of an endovascular device. The EmboTrap thrombectomy system features an inner stent channel with an outer stent trap design that may potentially reduce the risk of distal clot fragmentation during clot removal. We tested the hypothesis that distal emboli to both the same and new territory generated during mechanical thrombectomy are a function of device design...
October 2017: Interventional Neurology
John D Nerva, Ryan P Morton, Cory M Kelly, Danial K Hallam, Michael R Levitt
BACKGROUND AND IMPORTANCE: Coil migration is a potential complication of endovascular aneurysm treatment. Dislodged coils into the parent artery require retrieval to prevent thromboembolic complications. A variety of techniques for coil retrieval have been described, including the use of single stentrievers and aspiration catheters. CLINICAL PRESENTATION: The use of 2 stentrievers, as opposed to a single device, was thought to be advantageous in coil removal by the additional point of friction due to the extensive length of coil stretching and earlier failure of a single device...
November 2, 2017: Operative Neurosurgery (Hagerstown, Md.)
Sunil A Sheth, Abhishek Verma, Konark Malhotra, Xiannan Tang, Satoshi Tateshima, Reza Jahan, Jason D Hinman
BACKGROUND: Endovascular treatment for large-vessel acute ischemic stroke (AIS) has rapidly emerged. However, the understanding of the complex biology involving endothelial cells (ECs) remains scarce. METHODS: Using stent retrievers during endovascular thrombectomy (ET) in patients with AIS, ECs were segregated, centrifuged in a dissociation buffer, and suspended in endothelial specific antibody solution. Subsequently, fluorescence-activated cell sorting (FACS) and microscopic analyses were performed...
November 2, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
R Xu, X-K Zhao, M-L Wang, X Liu, D Xi
OBJECTIVE: Acute ischemic stroke (AIS) is an important global health problem. Intravenous (IV) thrombolysis with recombinant tissue plasminogen activator (rt-PA) is the standard treatment. However, only a small number of patients benefit from it because of strict application restrictions. Increasing evidence has demonstrated that mechanical thrombectomy is an effective and safe therapy for AIS. PATIENTS AND METHODS: We present 14 cases of successful recanalization with Solitaire devices for AIS patients after stroke onset...
October 2017: European Review for Medical and Pharmacological Sciences
Qiang Fu, Xiaobin Guo, Dapeng Mo, Buxing Chen
Paradoxical embolization is the mechanism for patent foramen ovale (PFO)-associated cryptogenic stroke and transcatheter closure of PFO may prevent recurrent ischemic stroke. Mechanical thrombectomy is promising to treat acute ischemic stroke due to high rates of reperfusion and reduced intracranial hemorrhage complications. We report the case of a 27-year-old woman with a massive cerebral infarction but no evidence for any atherosclerosis, who received an urgent mechanical thrombectomy with a Solitaire device...
October 21, 2017: International Heart Journal
Hongchen Zhao, Jinhua Zhang, Danyan Gu, Zongjie Shi, Jie Pan, Yu Geng, Tianming Shi
The aim of the present study was to assess the use of tirofiban injections for rescue therapy following artery reocclusion due to intra-luminal thrombosis during endovascular thrombectomy in patients with acute ischemic stroke (AIS). A total of seven cases of patients treated with adjunctive tirofiban injections following failed endovascular thrombectomy due to instant intra-luminal thrombosis were retrospectively assessed. A Solitaire stent was used as the primary thrombectomy device in all patients. Tirofiban was injected intra-arterially via a temporarily deployed Solitaire stent with continuous intravenous infusion for the subsequent 24 h; half of the conventionally recommended dose was employed...
October 2017: Experimental and Therapeutic Medicine
Rakeshsingh K Singh, Vishal Annaji Chafale, Rakesh Shyam Lalla, Keyurkumar Chandrakantbhai Panchal, Anil Pandurang Karapurkar, Satish Vasant Khadilkar, Pawan K Ojha, Yogesh Godge, Rakesh K Singh, Rajesh Benny
BACKGROUND: Mechanical thrombectomy (MT) is the most effective treatment in large vessel occlusion (LVO). We have analyzed our initial experience of MT of 137 patients in anterior circulation (AC) and posterior circulation (PC) LVO using Solitaire stent retriever device. METHODS: Retrospective cohort analysis of 112 AC and 25 PC acute ischemic strokes was done considering various baseline characteristics, risk factors, National Institute of Health Stroke Scale (NIHSS) change, revascularization rate, complications, and functional outcome at 3 months using modified Rankin score...
July 2017: Annals of Indian Academy of Neurology
Felix Zibold, Pasquale Mordasini, Pascal Mosimann, Eike Piechowiak, Tomas Dobrocky, Urs Fischer, Marcel Arnold, Sebastian Bellwald, Jan Gralla
PURPOSE: Stent retrievers apply mechanical force to the intracranial vasculature. Our aim was to evaluate the safety and efficacy of the long Solitaire 4 × 40 mm stent retriever for large vessel occlusion in stroke patients. METHODS: We conducted a retrospective analysis of all patients treated for acute ischemic large vessel occlusion stroke with the Solitaire 2 FR 4 × 40 device between May and October 2016 at our institution. Patient-specific data at baseline and at discharge were documented...
September 1, 2017: Cardiovascular and Interventional Radiology
Nils H Mueller-Kronast, Osama O Zaidat, Michael T Froehler, Reza Jahan, Mohammad Ali Aziz-Sultan, Richard P Klucznik, Jeffrey L Saver, Frank R Hellinger, Dileep R Yavagal, Tom L Yao, David S Liebeskind, Ashutosh P Jadhav, Rishi Gupta, Ameer E Hassan, Coleman O Martin, Hormozd Bozorgchami, Ritesh Kaushal, Raul G Nogueira, Ravi H Gandhi, Eric C Peterson, Shervin R Dashti, Curtis A Given, Brijesh P Mehta, Vivek Deshmukh, Sidney Starkman, Italo Linfante, Scott H McPherson, Peter Kvamme, Thomas J Grobelny, Muhammad S Hussain, Ike Thacker, Nirav Vora, Peng Roc Chen, Stephen J Monteith, Robert D Ecker, Clemens M Schirmer, Eric Sauvageau, Alex Abou-Chebl, Colin P Derdeyn, Lucian Maidan, Aamir Badruddin, Adnan H Siddiqui, Travis M Dumont, Abdulnasser Alhajeri, M Asif Taqi, Khaled Asi, Jeffrey Carpenter, Alan Boulos, Gaurav Jindal, Ajit S Puri, Rohan Chitale, Eric M Deshaies, David H Robinson, David F Kallmes, Blaise W Baxter, Mouhammad A Jumaa, Peter Sunenshine, Aniel Majjhoo, Joey D English, Shuichi Suzuki, Richard D Fessler, Josser E Delgado Almandoz, Jerry C Martin, Diogo C Haussen
BACKGROUND AND PURPOSE: Mechanical thrombectomy with stent retrievers has become standard of care for treatment of acute ischemic stroke patients because of large vessel occlusion. The STRATIS registry (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke) aimed to assess whether similar process timelines, technical, and functional outcomes could be achieved in a large real world cohort as in the randomized trials. METHODS: STRATIS was designed to prospectively enroll patients treated in the United States with a Solitaire Revascularization Device and Mindframe Capture Low Profile Revascularization Device within 8 hours from symptom onset...
October 2017: Stroke; a Journal of Cerebral Circulation
Agnieszka Słowik, Marcin Wnuk, Paweł Brzegowy, Joanna Chrzanowska-Waśko, Aleksandra Golenia, Bartłomiej Łasocha, Dorota Włoch-Kopeć, Antoni Ferens, Wojciech Serednicki, Piotr Jarocki, Halina Bartosik-Psujek, Rafał Kaczorowski, Edward Filip, Monika Grzegorzak, Jarosław Homa, Janusz Darocha, Daniel Dudek, Wiesław Guz, Konrad Rejdak, Piotr Luchowski, Joanna Wojczal, Michał Sojka, Michał Górnik, Sylwia Stachowicz, Jacek Jaworski, Kinga Buraczyńska, Remigiusz Ficek, Anna Szczepańska-Szerej, Tomasz Jargiełło, Małgorzata Szczerbo-Trojanowska, Anetta Lasek-Bal, Przemysław Puz, Aldona Warsz-Wianecka, Arkadiusz Stęposz, Krzysztof Ziaja, Wacław Kuczmik, Tomasz Urbanek, Damian Ziaja, Witold Tomalski, Adam Kobayashi, Przemysław Richter, Andrzej Płoński, Marcin Kotkowski, Wojciech Czepiel, Iwona Kurkowska-Jastrzębska, Halina Sienkiewicz-Jarosz, Anna Członkowska, Beata BłażejewskaHyżorek, Danuta Ryglewicz, Magdalena Konopko, Edyta Brelak, Jacek Antecki, Igor Szydłowski, Maciej Włosek, Adam Stępień, Krzysztof Brzozowski, Jacek Staszewski, Piotr Piasecki, Piotr Zięcina, Izabela Wołoszyńska, Norbert Kolmaga, Jerzy Narloch, Tomasz Hasiec, Jacek Gawłowicz, Monika Pędracka, Jacek Porębiak, Bogumił Grzechnik, Vadym Matsibora, Michał Frąszczak, Marcin Leus, Maciej Mazgaj, Violetta Palacz-Duda, Grzegorz Meder, Wojciech Skura, Piotr Płeszka, Milena Świtońska, Krzysztof Słomiński, Józef Kościelniak, Paulina Sobieszak-Skura, Magdalena Konieczna-Brazis, Olgierd Rowiński, Andrzej Opuchlik, Anatol Mickielewicz, Beata Szyluk, Piotr Szczudlik, Anna Kostera-Pruszczyk, Maciej Jaworski, Rafał Maciąg, Jarosław Żyłkowski, Bożena Adamkiewicz, Wojciech Szubert, Jarosław Chrząstek, Marek Raźniewski, Agnieszka Pawelec, Paweł Wilimborek, Ryszard Wagner, Paweł Pilarski, Paweł Gierach, Jan Baron, Wojciech Gruszka, Stanisław Ochudło, Agnieszka Krzak-Kubica, Monika Rudzińska-Bar, Miłosz Zbroszczyk, Kamila Smulska, Michał Arkuszewski, Dorota Różański, Dariusz Koziorowski, Izabela Meisner-Kramarz, Stanisław Szlufik, Artur Zaczyński, Krzysztof Kądziołka, Kazimierz Kordecki, Michał Zawadzki, Mirosław Ząbek, Bartosz Karaszewski, Dariusz Gąsecki, Paweł Łowiec, Waldemar Dorniak, Tomasz Gorycki, Edyta Szurowska, Ewa Wierzchowska-Cioch, Tomasz Smyk, Beata Szajnoga, Marcin Bachta, Kajetan Mazurek, Magdalena Piwowarska, Wojciech Kociemba, Artur Drużdż, Adrian Dąbrowski, Michał Glonek, Małgorzata Wawrzyniak, Radosław Kaźmierski, Robert Juszkat, Witold Tomalski, Adam Heliosz, Adam Ryszczyk, Jacek Zwiernik, Grzegorz Wasilewski, Andrzej Tutaj, Grzegorz Dałek, Krzysztof Nosek, Sławomir Bereza, Katarzyna Lubkowska, Jerzy Kamienowski, Piotr Sobolewski, Adam Bielecki, Maciej Miś, Marcin Miś, Maria Krużewska-Orłowska, Jan Kochanowicz, Zenon Mariak, Marta Jakoniuk, Grzegorz Turek, Urszula Łebkowska, Andrzej Lewszuk, Kazimierz Kordecki, Tomasz Dziedzic, Tadeusz Popiela
OBJECTIVES: Mechanical thrombectomy (MT) is not reimbursed by the Polish public health system. We present a description of 5 years of experience with MT in acute stroke in Comprehensive Stroke Centers (CSCs) in Poland. METHODS AND RESULTS: We retrospectively analyzed the results of a structured questionnaire from 23 out of 25 identified CSCs and 22 data sets that include 61 clinical, radiological and outcome measures. RESULTS: Most of the CSCs (74%) were founded at University Hospitals and most (65...
September 2017: Neurologia i Neurochirurgia Polska
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