Percutaneous Transluminal Angioplasty and Stent Placement in Acute Vessel Occlusion: Evaluation of New Methods for Interventional Stroke Treatment

Abstract

BACKGROUND AND PURPOSE:The major goal of acute ischemic stroke treatment is fast and sufficient recanalization. Percutaneous transluminal balloon angioplasty (PTA) and/or placement of a stent might achieve both by compressing the thrombus at the occlusion site. This study assesses the feasibility, recanalization rate, and complications of the 2 techniques in an animal model.

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

“…The radial force of the device is sufficient to compress the thrombus against the vessel wall and to restore blood flow immediately after deployment. Consistent with previous experimental findings 14 and clinical experience, the thrombus is compressed against the vessel wall opposite the initial passing site. No thrombus fragmentation or dislocation during deployment or expansion of the stent during the observation period with the device in place was observed, indicating sufficient stabilization and coverage of the thrombus by the stent struts.…”

In Vivo Evaluation of the Phenox CRC Mechanical Thrombectomy Device in a Swine Model of Acute Vessel Occlusion

“…In all cases passing of the thrombus occurred between the thrombus and the vessel wall without penetrating the thrombus, consistent with the findings in other studies 12,13,21 and clinical experience. Unsheathing of the device distally to the thrombus was feasible without complications.…”

Experimental Evaluation of Immediate Recanalization Effect and Recanalization Efficacy of a New Thrombus Retriever for Acute Stroke Treatment In Vivo

“…At the latter time, expansion of the device allowed partial recanalization of the target vessel in 75% (12/16) of cases, consistent with previous experimental and clinical studies. 4,6,8,13 Due to the radiopacity of thrombus gained by the added barium sulfate, thrombus-device interaction was shown in detail on the imaging with high-resolution FPCT. 3D volume imaging as well as multiplanar and maximum intensity projection reconstructions of the FPCT raw data showed the thrombus incorporated within the stent struts.…”

“…[6][7][8][9][10][14][15][16][17] In our experience, it provides valuable insights into the principle of action of different thrombectomy approaches. However, the model has its inherent shortcomings.…”

“…[6][7][8][9][10] In brief, thrombi were generated by mixing 10 mL of autologous blood with 1 g of barium sulfate and 0.25 mL of bovine thrombin solution (Dade thrombin reagent; Siemens Healthcare Diagnostics, Erlangen, Germany). After an incubation time of 1 hour at room temperature, the material was cut into thrombi of 10-mm length for injection into the target vessel.…”