In Vivo Evaluation of the First Dedicated Combined Flow-Restoration and Mechanical Thrombectomy Device in a Swine Model of Acute Vessel Occlusion

Abstract

BACKGROUND AND PURPOSE:The use of self-expanding retrievable stents is an emerging and promising treatment strategy for acute stroke treatment. The concept combines the advantages of stent deployment with immediate flow-restoration and of mechanical thrombectomy with definitive thrombus removal. The present study was performed to gain more knowledge about the principle of combined flow restoration and thrombectomy in an established animal model using radiopaque thrombi evaluating efficiency, thrombus-device interaction and possible complications of the first dedicated flow-restoration and mechanical thrombectomy device.

Frequency and Relevance of Anterior Cerebral Artery Embolism Caused by Mechanical Thrombectomy of Middle Cerebral Artery Occlusion

“…Three years later the same group tested the Solitaire FR in an identical setting and did not observe any distal emboli during passage, deployment, and retraction. 16 These results suggest differences between devices and a clear superiority of the stent-retriever approach in terms of embolic events. In our case series as well as in the RECOST study, loss of thrombus material occurred with the use of stent retrievers and we did not find any statistical difference between devices.…”

Histopathologic Evaluation of Arterial Wall Response to 5 Neurovascular Mechanical Thrombectomy Devices in a Swine Model

“…The Solitaire FR 6 mm exerts a greater radial force at all diameters compared with the Solitaire FR 4 mm. The increased intimal tearing could be attributed to the greater length of the Solitaire FR 4 mm (31.8 versus 26.2 mm), 21 having more surface area in contact with the vessel wall. Thus radial force could be considered a less important contributor to arterial wall injury.…”

“…The first in vivo model dedicated to MET in ischemic stroke was reported by Gralla et al 18 It permits an angiographic evaluation and comparison of neurovascular mechanical thrombectomy devices. 9,[19][20][21] However, no study has evaluated the histopathologic responses induced by devices, to our knowledge. Recently, a model has been specifically developed in swine, by using the superficial cervical artery to evaluate arterial structural changes.…”

Technical Feasibility and Application of Mechanical Thrombectomy with the Solitaire FR Revascularization Device in Acute Basilar Artery Occlusion

“…Once fully deployed, a control angiogram was obtained to assess immediate recanalization effect. According to the results of previous animal and clinical studies, 10,18 the device was left in place for 5 minutes to allow the clot to become embedded in the stent before the microcatheter was then advanced to partially resheath the proximal connection site of the stent to the pusher wire. The Solitaire FR and the microcatheter were retrieved simultaneously during aspiration with a 60-mL syringe at the guide catheter.…”