Article Text

Download PDFPDF
Response to ‘plunge with caution: safeguarding patients in mechanical thrombectomy’
  1. Michael T Froehler1,
  2. Bryan C Good2
  1. 1Cerebrovascular Program, Vanderbilt University Medical Center, Nashville, Tennessee, USA
  2. 2Department of Mechanical, Aerospace Biomedical Engineering, University of Tennessee, Knoxville, Tennessee, USA
  1. Correspondence to Dr Michael T Froehler, Cerebrovascular Program, Vanderbilt University Medical Center, Nashville, Tennessee, USA; m.froehler{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

We thank the authors for their interest in the ‘plunger’ technique for direct aspiration thrombectomy and appreciate the concerns they raised about patient safety after watching our technical video1,2.

First, we would like to clarify how the plunger technique is performed. While it would seem obvious to almost any neuro-interventionalist, we must emphasize that at no point is the plunger actively pushed forward. In the video,2 the manual technique of cyclic aspiration is demonstrated at slow and fast speeds during a patient case. The plunger technique is initiated identically to standard manual aspiration, in our case with a 60 cc VacLok syringe being fully opened to 60 mL, to create a vacuum within the closed clot-catheter-syringe system. The syringe plunger is then released, not pushed, allowing it to naturally return to …

View Full Text


  • Contributors Both authors contributed equally to this letter.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

Linked Articles