Introduction First pass effect (FPE) and final full reperfusion are strongly related to good clinical outcome. Stent-retriever thrombectomy produces numerous emboli reducing the rates of FPE.
Aim of Study Stent-retrievers with built in distal emboli filters (Neva Net, Vesalio) improve FPE and reduce distal emboli.
Methods Simulated use mechanical thrombectomy of a validated middle cerebral artery occlusion was conducted in a model system composed of a human vascular replica of the entire circle of Willis. The replica was perfused with blood mimicking fluid at physiologically correct pressure and flows. A friable bovine clot was introduced into the right ICA leading to complete occlusion of the right M1 segment. The test article (NevaNet) was compared to gold standard stent-retriever thrombectomy with the Solitaire device (Medtronic, Irvine CA). Block randomization and 10 replicate experiments for each device were performed. Number of passes for complete recanalization were measured and all effluent was separately collected from the MCA and ACA territories for emboli analysis.
Results FPE was achieved in all cases with the Neva Net and only 60% with the control device (p=0.03). Median number of clot fragments with a diameter of 1 mm or more was 4-fold higher with the control device versus the Neva Net (p=0.037). More clot fragments with diameters between 0.2 and 1 mm were found in the control group versus the Neva Net (p=0.048).
Conclusion Stent-retrievers with embolic filters reduce the amount of thromboemboli and show increased first pass complete recanalization.
Disclosure of Interest VA,ME:Nothing to disclose
MG: No relevant disclosures
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