Abstract
Introduction
To describe a new device meant for rapid endovascular thrombectomy of intracranial arteries of various sizes and its first clinical use.
Methods
A device with oriented microfilaments was constructed that consists of a core wires compound surrounded by a dense palisade of perpendicular-oriented stiff polyamid microfilaments (phenox clot retriever). The device is introduced into the target vessel through a 0.021- or 0.027-inch microcatheter, deployed distally to the thrombus, and slowly pulled back under continuous aspiration via the guiding catheter.
Results
The clinical use of the phenox clot retriever in two successive patients is described. Case 1: In a 78-year-old patient with acute posterior circulation ischemia not eligible for intravenous or intraarterial thrombolysis, endovascular recanalization of the occluded left V4 segment was possible using the phenox clot retriever within a few minutes. Case 2: A 70-year-old patient presented after the sudden onset of a left upper extremity paresis 1 day after abdominal surgery. Angiography revealed a thromboembolic occlusion of two cortical branches of the right middle cerebral artery. The rolandic artery was recanalized by a single passage of the phenox clot retriever, with complete neurological recovery.
Conclusion
The phenox clot retriever, a flexible microfilament pattern, might be a useful supplement to the repertoire of currently available devices for endovascular intracranial thrombectomy.
References
Higashida RT. Recent advances in the interventional treatment of acute ischemic stroke. Cerebrovasc Dis 2005;20 (Suppl 2): 140–147.
Chapot R, Houdart E, Rogopoulos A, et al. Thromboaspiration in the basilar artery: report of two cases. AJNR Am J Neuroradiol 2002;23:282–284.
Brekenfeld C, Remonda L, Nedeltchev K, et al. Endovascular neuroradiological treatment of acute ischemic stroke: techniques and results in 350 patients. Neurol Res 2005;27:S27-S35.
Mayer TE, Hamann GF, Brueckmann HJ. Treatment of basilar artery embolism with a mechanical extraction device. Necessity of flow reversal. Stroke 2002;33:2232–2235.
Lutsep HL, Clark WM, Nesbit GM et al. Intraarterial suction thrombectomy in acute stroke. AJNR Am J Neuroradiol 2002;23:783–786
Fourie, P, Duncan IC. Microsnare-assisted mechanical removal of intraprocedural distal middle cerebral arterial thromboembolism. AJNR Am J Neuroradiol 2003;24:630–632.
Bergui M, Stura G, Daniele D, et al. Mechanical thrombolysis in ischemic stroke attributable to basilar artery occlusion as first-line treatment. Stroke 2006;37:145–150.
Smith WS, Sung G, Starkman S, et al. Safety and efficacy of mechanical embolectomy in acute ischemic stroke: results of the MERCI trial. Stroke 2005;36:1432–1438.
Asakura F, San Millan D, Abdo G, et al. Preclinical in-vitro evaluation of a clot retrieval device for cerebral embolism. Intervent Neuroradiol 2005;11(Suppl 2):160.
Versnick EJ, Do HM, et al. Mechanical thrombectomy for acute stroke. AJNR Am J Neuroradiol 2005;26:875–879.
Chapot R. First experience with the Catch, a new device for cerebral thrombectomy. Intervent Neuroradiol 2005;11(Suppl 2):58.
Alexandrov AV, Molina CA, Grotta JC, et al. Ultrasound-enhanced systemic thrombolysis for acute ischemic stroke. N Engl J Med 2004;351:2170–2178.
Mahon BR, Nesbit GM, Barnwell SL, et al. North American clinical experience with the EKOS MicroLysUS infusion catheter for the treatment of embolic stroke. AJNR Am J Neuroradiol 2003;24:534–538.
Berlis A, Lutsep H, Barnwell S, et al. Mechanical thrombolysis in acute ischemic stroke with endovascular photoacoustic recanalization. Stroke 2004;35:1112–1116.
Mayer TE, Hamann GF, Schulte-Altedorneburg G, et al. Treatment of vertebrobasilar occlusion by using a coronary waterjet thrombectomy device: a pilot study. AJNR Am J Neuroradiol 2005;26:1389–1394.
Bellon RJ, Putman CM, Budzik RF, et al. Rheolytic thrombectomy of the occluded internal carotid artery in the setting of acute ischemic stroke. AJNR Am J Neuroradiol 2001;22:526–530.
Schumacher HC, Meyers PM, Yavagal DR, et al. Endovascular mechanical thrombectomy of an occluded superior division branch of the left MCA for acute cardioembolic stroke. Cardiovasc Intervent Radiol 2003;26:305–308.
Kirton A, Wong JH, Mah J, et al. Successful endovascular therapy for acute basilar thrombosis in an adolescent. Pediatrics 2003;112: 248–251.
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Henkes, H., Reinartz, J., Lowens, S. et al. A device for fast mechanical clot retrieval from intracranial arteries (phenox clot retriever). Neurocrit Care 5, 134–140 (2006). https://doi.org/10.1385/NCC:5:2:134
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DOI: https://doi.org/10.1385/NCC:5:2:134