Article Text

Original research
No inferiority of Tonbridge thrombectomy device for acute thrombus retrial compared with Solitaire device: an experimental evaluation with a canine distal external carotid-maxillary artery occlusion model
  1. Geng Zhou1,
  2. Ming-Hua Li1,
  3. Hai-Tao Lu1,
  4. Jiang-Shan Deng2,
  5. Yu-Wu Zhao2,
  6. Yi Xiang J Wang3,
  7. Yue-Qi Zhu1
  1. 1Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
  2. 2Department of Neurology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
  3. 3Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
  1. Correspondence to Dr. Hai-Tao Lu, Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital Shanghai China ; luhaitao1975{at} and Dr Yue-Qi Zhu, Departmentof Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai 200233, China; zhuyueqi{at}


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). Final flow restoration, side branches, recanalization time, distal vessel embolism, and device-related complications were recorded and compared. A post-procedure angiogram was obtained at 30 and 90 days after thrombectomy. Device manipulation-related damage to the arterial walls was evaluated histologically.

Results In vitro test showed that the maximum friction within the microcatheter was 0.763 for the Tonbridge device and 0.784 n for the Solitaire (P>0.05). Slight increase in radial force was noticed for the Tonbridge (0.035 N/mm vs 0.031 N/mm of Solitaire, P>0.05). Eighteen and 16 retriever attempts were done in the Tonbridge (mean 2.0 attempts) and the Solitaire (mean 1.8 attempts) groups (P=0.74). The Tonbridge device led to good flow restoration in all nine (100%) models compared with eight (88.9%) in the Solitaire group (P=0.30). Side branches' influence (P=0.39), distal thromboembolism (P=0.60), and device-related complications (P=1.00) found no difference between the two groups. The rates of disruption of the internal elastic lamina (IEL) were 8.3% (2/24) and 4.2% (1/24) of the specimens, respectively (P=0.683). TICI 2b/3 flow of the right CCA were similar between the two groups at 1 (6/6 vs 6/6) and 3 months (6/6 vs 6/6) follow-up (P>0.05).

Conclusion Our preliminary study indicated this new device was technically feasible and effective to be used in thrombectomy for the treatment of acute thrombus occlusion in canine models.

  • stroke
  • stent
  • thrombectomy

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  • Contributors YQZ: study conception, design of the work, acquisition of data, interpretation of data, drafting of the manuscript. GZ, JSD: data acquisition, statistical analysis, critical revision of manuscript. MHL, YWZ, YXW: critical revision of manuscript. HTL: interpretation of data and critical revision of manuscript.

  • Funding Grants from the national natural science foundation of China (No. 81370041,81671655, 81471760); Shanghai municipal education commission - Gaofeng clinical medicine grant support (No.20152528); Shanghai Pujiang program (16PJD036); three-year plan program by Shanghai Shen Kang hospital development center (16CR3043A); Shanghai science and technology commission of Shanghai municipality program (14DZ1941206).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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