In vitro-Testung eines Kathetermodells mit einer trichterförmig erweiterten Spitze zur Reduktion von Thrombusmigration unter Verwendung von verschiedenen Thrombuskompositionen für die mechanische Thrombektomie
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Abstract
Clot-retrieval failure and embolism in new territories (ENT) are complications reducing the ecacy ofmechanical thrombectomy (MT). Reasons for these problems are clot abruption during stent retrieverretraction into the cylindrical tip of a standard distal access catheter (DAC), and antegrade blood owduring retrieval. To overcome these complications, a funnel-shaped tip catheter model was developed andtested. Using an experimental in vitro setup, this study compared the ecacy of a funnel-shaped tip witha standard cylindrical tip in combination with different clot compositions. Mechanical thrombectomy wasperformed 80 times for each tip, using two stent retrievers (Trevo XP ProVue 3/20 mm and 4/20 mm) andfour different clot types (mechanical vs. static preparation, 0-24h vs. 72h clot aging times). Signicantlyhigher rst-pass recanalization rates were observed for the funnel-shaped tip, which reached 70.0% vs.30.0% for the standard tip (absolute difference, 32; relative difference 20.0%, P < 0.05), regardless of theclot type and stent retriever. Recanalization could be increased using brin-rich mechanical clots vs. clotsprepared under static conditions, as well as 0-24h vs. 72h aged clots, respectively. The extended in vitro-experiments veried the usability of the recently patented funnel-shaped DAC, hereby implementing next-level in vivo-experiments.