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Stroke

New mechanical clot retrieval devices show superiority in patients with acute ischaemic stroke

Nature Reviews Neurology volume 8, page 531 (2012)Cite this article

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Two new mechanical clot retrieval devices are superior to the current standard device for achieving recanalization in cases of stroke caused by large-vessel occlusion, according to new trial results published in The Lancet. The Trevo® Retriever (Stryker Neurovascular, Mountain View, CA, USA) and the Solitaire Flow Restoration Device (Covidien/ev3, Dublin, Ireland) were both found to be more effective than the Merci Retriever (Stryker Neurovascular), which was the first clot retrieval device to be approved by the FDA.

Mechanical clot retrieval is a treatment option for patients with large-vessel occlusion strokes who are ineligible for—or have failed to respond adequately to—thrombolysis with recombinant tissue plasminogen activator. The retrieval device is deployed to the occluded vessel via a microcatheter. Unlike the Merci Retriever, which uses a corkscrew-shaped coil, the new devices employ a stent-like cage to trap the clot. Stent retrievers are thought to offer a number of advantages over coil retrievers, including better engagement with the clot, and a reduced propensity to damage the wall of the blood vessel.

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References

ORIGINAL RESEARCH PAPERS

  1. Nogueira, R. G. et al. Trevo versus Merci retrievers for thrombectomy revascularisation of large vessel occlusions in acute ischaemic stroke (TREVO 2): a randomised trial. Lancet doi:10.1016/S0140-6736(12)61299-9

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  2. Saver, J. L. et al. Solitaire flow restoration device versus the Merci Retriever in patients with acute ischaemic stroke (SWIFT): a randomised, parallel-group, non-inferiority trial. Lancet doi:10.1016/S0140-6736(12)61384-1

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FURTHER READING

  1. Nogueira, R. G. et al. The Trevo device: preclinical data of a novel stroke thrombectomy device in two different animal models of arterial thrombo-occlusive disease. J. Neurointerv. Surg. 4, 295–300 (2011)

    Article  PubMed  Google Scholar 

  2. Pérez, M. A. et al. Intracranial thrombectomy using the Solitaire stent: a historial vignette. J. Neurointerv. Surg. doi:10.1136/neurintsurg-2011-010149

    Article  PubMed  PubMed Central  Google Scholar 

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Authors
  1. Heather Wood
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Wood, H. New mechanical clot retrieval devices show superiority in patients with acute ischaemic stroke. Nat Rev Neurol 8, 531 (2012). https://doi.org/10.1038/nrneurol.2012.196

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  • DOI: https://doi.org/10.1038/nrneurol.2012.196

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