0000000000065354
AUTHOR
Martin Büsen
Necessary Catheter Diameters for Mechanical Thrombectomy with ADAPT
BACKGROUND AND PURPOSE: Large-bore catheters allow mechanical thrombectomy in ischemic stroke by engaging and retrieving clots without additional devices (direct aspiration first-pass technique [ADAPT]). The purpose of this study was to establish a model for minimal catheter diameters needed for ADAPT. MATERIALS AND METHODS: We established a theoretic model for the calculation of minimal catheter diameters needed for ADAPT. We then verified its validity in 28 ADAPT maneuvers in a porcine in vivo model. To account for different mechanical thrombectomy techniques, we factored in ADAPT with/without a hypothetic 0.021-inch microcatheter or 0.014-inch microwire inside the lumen of the aspiration…
Optimizing endovascular stroke treatment: removing the microcatheter before clot retrieval with stent-retrievers increases aspiration flow
BackgroundFlow control during endovascular stroke treatment with stent-retrievers is crucial for successful revascularization. The standard technique recommended by stent-retriever manufacturers implies obstruction of the respective access catheter by the microcatheter, through which the stent-retriever is delivered. This, in turn, results in reduced aspiration during thrombectomy. In order to maximize aspiration, we fully retract the microcatheter out of the access catheter before thrombectomy—an approach we term the ‘bare wire thrombectomy’ (BWT) technique. We verified the improved throughput with systematic in vitro studies and assessed the clinical effectiveness and safety of this metho…
Under Pressure: Comparison of Aspiration Techniques for Endovascular Mechanical Thrombectomy.
BACKGROUND AND PURPOSE: Blood flow should be interrupted during mechanical thrombectomy to prevent embolization of clot fragments. The purpose of our study was to provide a handy overview of the most common aspiration devices and to quantify their flow characteristics. MATERIALS AND METHODS: We assessed volumetric flow rates generated by a 60-mL VacLok vacuum pressure syringe, a Pump MAX aspiration pump, and a Dominant Flex suction pump connected to the following: 1) an 8F long sheath, 2) an 8F balloon-guide catheter, 3) an ACE 64 distal aspiration catheter, and 4) an AXS Catalyst 6 Distal Access Catheter. We used a water/glycerol solution, which was kept at a constant temperature of 20°C (…