A novel mechanical thrombectomy device for retrieval of intravascular thrombus.
OBJECTIVE
Thrombotic and embolic vascular occlusion represents a leading cause of morbidity and mortality. Currently available thrombectomy devices have limitations, including difficulty removing organized thrombus and clot fragmentation with distal embolization. A novel mechanical thrombectomy device (MTD), designed to remove both hard and soft thrombus without trauma to the blood vessel, was tested in preclinical porcine models evaluating efficacy, safety, and ease of use.


METHODS
A total of 26 vessels in 14 pigs underwent mechanical thrombectomy with MTD. Thrombectomy was performed in nine superficial femoral arteries, eight subclavian arteries, five primary branches of the subclavian artery, lateral thoracic artery or the thyrocervical trunk, and four external carotids. Subacute organized fibrin-laden thrombus was injected into the arteries producing vascular occlusion. The MTD was then used for thrombectomy to restore patency and blood flow.


RESULTS
Intact thrombus was retrieved from 24 of 26 of the vessels with a single pass of the MTD, resulting in complete restoration of patency in 21 vessels and partial patency in 4 vessels. In 8 cases that used an early design, the embolic material fragmented during withdrawal from the access sheath. In 4 procedures that used an early design, the MTD failed to deploy fully and the embolus was not completely captured. No intraprocedural complications or vascular damage occurred.


CONCLUSIONS
The present pilot studies demonstrate basic safety and efficacy of a novel MTD with design attributes suitable for retrieval of intact acute and organized chronic thrombus. The device has potential intracranial and peripheral utility.
Department of Radiology, University of California Davis Medical Center, Sacramento, CA 95817, USA. wayne.monsky@ucdmc.ucdavis.edu
Wayne L
WL
Monsky
Stephanos
S
Finitsis
Dino
D
De Cicco
John M
JM
Brock
John
J
Kucharczyk
Richard E
RE
Latchaw
D000818:Animals; D002342:Carotid Artery, External / Q000000981:diagnostic imaging; D004195:Disease Models, Animal; D004867:Equipment Design; D004868:Equipment Failure; D019544:Equipment Failure Analysis; D005263:Femoral Artery / Q000000981:diagnostic imaging; D010865:Pilot Projects; D011859:Radiography; D013348:Subclavian Artery / Q000000981:diagnostic imaging; D013552:Swine; D013895:Thoracic Arteries / Q000000981:diagnostic imaging; D017131:Thrombectomy / Q000295:instrumentation* / Q000379:methods; D013927:Thrombosis / Q000628:therapy*; D016896:Treatment Outcome; D014654:Vascular Patency