Potentially groundbreaking research was presented recently at the Society of NeuroInterventional Surgery (SNIS) annual meeting (22–26 July, Colorado Springs, USA), with Robert Starke (University of Miami Miller School of Medicine, Miami, USA) introducing a novel outcome metric, dubbed ‘complete clot ingestion’ (CCI), that aims to enhance the evaluation of success in thrombectomy procedures for acute ischaemic stroke treatment.
Starke’s presentation also outlined findings from a recent study assessing Von Vascular’s Algo smart pump device—equipped with adaptive pulsatile aspiration (APA) mode—in aspiration thrombectomy.
Today, the gold standard for stroke thrombectomy procedures is achieving radiographic reperfusion at the first pass—specifically, a thrombolysis in cerebral infarction (TICI) score of 2c/3. However, Starke’s research suggests that this measure alone may be insufficient, as it might not account for unvisualised distal emboli that could occur even when TICI 3 is achieved. The CCI metric intends to provide a more comprehensive assessment, defined by the complete ingestion of the clot into the catheter or pump canister, with no external clot remnants.
“We believe that the introduction of the CCI metric represents a significant advancement in evaluating the success of thrombectomy procedures,” said Starke, who is the lead investigator for the recent study involving the Algo device. “The Algo smart pump, with its APA mode, has shown promise in achieving more complete clot removal, thereby potentially improving patient outcomes. We are excited about the implications of this research and look forward to further clinical validation.”
The study compared two thrombectomy pump devices: the Algo smart pump (Von Vascular) and the Engine pump (Penumbra). Using an in-vitro synthetic clot analogue model, the research tested these devices in 360 thrombectomies across six catheter systems, focusing on CCI and the presence of distal emboli. In cases where CCI was achieved, there were zero instances of distal emboli, as compared with 7% in cases where CCI was not achieved.
As stated in a Von Vascular press release, the Algo smart pump featuring APA works via a novel mechanism that differs from conventional statistic or cyclical pumps—and the device demonstrated superior performance in achieving higher CCI rates in the present study.
“At Von Vascular, we are thrilled to see the Algo smart pump’s APA technology being recognised for its potential to enhance stroke thrombectomy,” said Manning Hanser, chief executive officer of Von Vascular. “This study underscores the importance of innovative approaches in thrombectomy devices, and we are committed to advancing stroke treatment for better patient care.”
According to the company, Starke’s research highlights the potential of the CCI metric as a valuable tool for assessing thrombectomy efficacy. The study’s results indicate that the Algo smart pump’s APA mode is particularly effective in minimising the risk of distal emboli too—although further clinical validation is necessary to confirm these findings, the release adds.
