Preclinical testing of a new clot-retrieving wire device using polyvinyl alcohol hydrogel vascular models.
BACKGROUND
Cerebral embolism is the principal cause of cerebral infarction. Recently, mechanical embolectomy has been proposed as an effective method. We performed a preclinical evaluation of a new mechanical clot-retrieving wire.


METHODS
This clot-retrieving wire consisted of three nitinol loops at the tip of a microguidewire. These three loops could be collapsed into a 0.018-inch wire compatible microcatheter. Each loop was 8 mm long and 3.5 mm wide. For simulation, polyvinyl alcohol (PVA) vascular anatomical models of the human carotid (eight models) and vertebrobasilar (three models) circulation were constructed. A pulsatile flow circulation system was used. Embolic clots were produced using pig blood plasma. The microcatheter and the microguidewire were advanced beyond the clot. The wire was then exchanged for the retrieving wire. The microcatheter was then pulled slightly back to open the loops. The clot was then caught by withdrawal of the system. Once caught, the clot was retrieved to the guiding catheter tip. We investigated the following points: ease of device deployment, clot capture ability, clot removal against blood flow and removal of the clot out of the introducer system.


RESULTS
A total of 104 procedures were performed in 11 PVA models and evaluated. The drop rate was 19%. We succeeded in partial and total recanalization in 51.0% of the procedures (53/104) within 30 minutes.


CONCLUSIONS
This new clot-retrieving wire could be useful for mechanical clot extraction in stroke.
Asakura
Fumio
F
Neuroradiology Unit, University Hospital of Geneva, 1211, Geneva, Switzerland.
Yilmaz
Hasan
H
Abdo
German
G
Sekoranja
Lucka
L
San Millan
Diego
D
Augsburger
Luca
L
Sztajzel
Roman
R
Ruefenacht
Daniel A
DA
Perren
Fabienne
F
Lovblad
Karl-Olof
KO
Goto
Katsuya
K
D017128:Embolectomy / Q000295:instrumentation*; D004867:Equipment Design; D006801:Humans; D020766:Intracranial Embolism / Q000517:prevention & control*; D008954:Models, Biological; D009532:Nickel; D011142:Polyvinyl Alcohol; D013193:Stainless Steel; D014025:Titanium
C062364:polyvinyl alcohol hydrogel; D013193:Stainless Steel; D009532:Nickel; D011142:Polyvinyl Alcohol; D014025:Titanium