PT  - JOURNAL ARTICLE
AU  - M. Mokin
AU  - S.V. Setlur Nagesh
AU  - C.N. Ionita
AU  - E.I. Levy
AU  - A.H. Siddiqui
TI  - Comparison of Modern Stroke Thrombectomy Approaches Using an In Vitro Cerebrovascular Occlusion Model
AID  - 10.3174/ajnr.A4149
DP  - 2015 Mar 01
TA  - American Journal of Neuroradiology
PG  - 547--551
VI  - 36
IP  - 3
4099  - http://www.ajnr.org/content/36/3/547.short
4100  - http://www.ajnr.org/content/36/3/547.full
SO  - Am. J. Neuroradiol.2015 Mar 01; 36
AB  - BACKGROUND AND PURPOSE: A new in vitro cerebrovascular occlusion model of the intracranial circulation was developed recently for testing thrombectomy devices. Using this model, we compared recanalization success associated with different modern endovascular thrombectomy approaches. MATERIALS AND METHODS: Model experiments were performed in 4 thrombectomy test groups: 1) primary or direct Stentriever thrombectomy with a conventional guide catheter (control group), 2) primary Stentriever thrombectomy with a balloon-guide catheter, 3) combined Stentriever–continuous aspiration approach, and 4) direct aspiration alone. Successful recanalization was defined as a TICI score of 2b or 3. RESULTS: Seventy-one thrombectomy experiments were conducted. Similar rates of TICI 2b–3 scores were achieved with balloon-guide and conventional guide catheters (P = .34). The combined Stentriever plus aspiration approach and the primary aspiration thrombectomy resulted in significantly higher rates of TICI 2b or 3 than the conventional guide-catheter approach in the control group (P = .008 and P = .0001, respectively). The primary Stentriever thrombectomy with the conventional guide catheter showed the highest rate of embolization to new territories (53%). CONCLUSIONS: Data from our in vitro model experiments show that the Stentriever thrombectomy under continuous aspiration and primary aspiration thrombectomy approaches led to the highest degree of recanalization. ADAPTdirect aspiration first pass techniqueEDTembolization in distal territoryENTembolization in new territorySWIFTSolitaire FR With the Intention for ThrombectomyTREVO 2Thrombectomy REvascularization of large Vessel Occlusions in acute ischemic stroke