Research presented at the ongoing Society of NeuroInterventional Surgery (SNIS) annual meeting (31 July–4 August, San Diego, USA) has shown that different types of stent-retriever tips may result in improved patient outcomes when performing a mechanical thrombectomy to treat stroke.
While a minimally invasive thrombectomy procedure using a stent retriever device can be used to remove a clot and restore blood flow in a patient experiencing an acute ischaemic stroke, a neurointerventionist being unable to remove the entire blood clot at the first attempt due to clot fragmentation may mean multiple additional retrieval attempts are required—which, in turn, can lead to longer procedure times and worse clinical outcomes.
In a randomised, in-vitro study assessing the impact the design of a stent retriever’s tip has on distal embolisation of the blood clot during mechanical thrombectomy procedures, researchers in Spain created a model of the brain arterial system and used several types of stent retrievers to remove blood clot simulants. The stent retrievers used included those with open-tip, closed-tip and filter-tip designs.
They simulated 50 mechanical thrombectomies per each type of stent retriever, and found that the filter-tip stent retriever allowed them to fully retrieve the clot simulant at the first attempt 44% of the time—compared to 16% and 20% of the time for the open- and closed-tip devices, respectively.
“It is essential to continuously refine devices and techniques to improve stroke treatment,” said Jiahui Li (Vall d’Hebron Research Institute, Barcelona, Spain/Mayo Clinic, Rochester, USA), who was the lead author of this study. “Each clinical scenario demands specific tools and treatment approaches. Hopefully, this research will aid in evaluating the suitability of different devices for each stroke case, thus giving patients a better chance at recovery and functional independence.”