In vitro-Testung eines Kathetermodells mit einer trichterförmig erweiterten Spitze zur Reduktion von Thrombusmigration unter Verwendung von verschiedenen Thrombuskompositionen für die mechanische Thrombektomie

Abstract

Clot-retrieval failure and embolism in new territories (ENT) are complications reducing the ecacy 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 ecacy 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). Signicantlyhigher 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 veried the usability of the recently patented funnel-shaped DAC, hereby implementing next-level in vivo-experiments.