The first clinical use of a Russian stent retriever during thrombectomy in patients with ischaemic stroke

Abstract

Introduction. Endovascular thrombectomy with stent retrievers (SR) is effectively used to treat patients with ischaemic stroke due to thrombotic occlusion of large intracerebral arteries.

The aim of the study was to evaluate the ability of popular SR made overseas to grab the blood clot in vitro compared with the first Russian SR (Grasper, Angioline), as well as to analyze the first use of this SR in clinical practice.

Materials and methods. A comparative assessment of different SR: Trevo ProVue (Stryker), Penumbra (Penumbra Inc.), Solitaire (Medtronic), and Grasper (Angioline) and their ability to capture a blood clot in vitro was performed. A clinical evaluation of the safety and efficacy of the Grasper SR in patients with ischaemic stroke was conducted.

Results. No difference was found in the ability of the test devices to pass through torturous areas, and all devices successfully reached the target implantation zone without difficulty. The clot could be removed entirely in all cases, with no evidence of fragmentation during removal. Clinical testing of the Grasper SR demonstrated that its performance was comparable to the Solitaire SR in restoring intracerebral blood flow.

Conclusion. The obtained results from the in vitro study demonstrate comparable effectiveness of the Russian SR to its counterparts. The clinical study results show that the Grasper SR can effectively and safely remove blood clots in clinical settings but requires further study on a larger number of subjects.

For citation: Grachev N.I., Malaev D.U., Andreev M.N., Trebushat D.V., Syrovnev G.I., Loskutnikov M.A., Vakin T.M., Konstantinov V.I., Domashenko M.A. [The first clinical use of a Russian stent retriever during thrombectomy in patients with ischaemic stroke]. Annals of clinical and experimental neurology. 2021; 15(1): 80–88. (In Russ.). https://doi.org/10.25692/ACEN.2021.1.10

About the authors

Nikita I. Grachev

Primorsk Regional Clinical Hospital No. 1, Vladivostok

Author for correspondence.
Email: platonova@neurology.ru
Russian Federation

Dastan U. Malaev

State Novosibirsk Regional Clinical Hospital, Novosibirsk

Email: platonova@neurology.ru
Russian Federation

Mark N. Andreev

Angioline Group, Koltsovo, Novosibirsk region

Email: platonova@neurology.ru
Russian Federation

Dmitry V. Trebushat

Angioline Group, Koltsovo, Novosibirsk region

Email: platonova@neurology.ru
Russian Federation

Grigory I. Syrovnev

Angioline Group, Koltsovo, Novosibirsk region

Email: platonova@neurology.ru
Russian Federation

Mark A. Loskutnikov

Central Clinical Health Unit, Magnitogorsk

Email: platonova@neurology.ru
Russian Federation

Timofey M. Vakin

Central Clinical Health Unit, Magnitogorsk

Email: platonova@neurology.ru
Russian Federation

Viktor I. Konstantinov

Central Clinical Health Unit, Magnitogorsk

Email: platonova@neurology.ru
Russian Federation

Maksim A. Domashenko

Central Clinical Health Unit, Magnitogorsk

Email: platonova@neurology.ru
Russian Federation

References

  1. Kilic İ.D., Hakeem A., Marmagkiolis K. et al. Endovascular therapy for acute ischemic stroke: a comprehensive review of current status. Cardiovasc Revasc Med. 2019; 20(5):424–431. doi: 10.1016/j.carrev.2018.07.010. PMID: 30025660.
  2. Berkhemer O.A., Fransen P.S.S., Beumer D. et al. A randomized trial of intraarterial treatment for acute ischemic stroke. N Engl J Med. 2015; 372(1): 11–20. doi: 10.1056/NEJMoa1411587. PMID: 25517348.
  3. Goyal M., Menon B.K., van Zwam W.H. et al. Endovascular thrombectomy after large-vessel ischaemic stroke: A meta-analysis of individual patient data from five randomised trials. Lancet. 2016; 387(10029): 1723–1731. doi: 10.1016/S0140-6736(16)00163-X. PMID: 26898852.
  4. Campbell B.C.V., Mitchell P.J., Kleinig T.J. et al. Endovascular therapy for ischemic stroke with perfusion-imaging selection. N Engl J Med. 2015; 372(11): 1009–1018. doi: 10.1056/NEJMoa1414792. PMID: 25671797.
  5. Kang D.H., Park J. Endovascular stroke therapy focused on stent retriever thrombectomy and direct clot aspiration: Historical review and modern application. J Korean Neurosurg Soc. 2017; 60(3): 335–347. doi: 10.3340/jkns.2016.0809.005. PMID: 28490161.
  6. Powers W.J., Rabinstein A.A., Ackerson T. et al. Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2019; 50(12): e344–e418. doi: 10.1161/STR.0000000000000211. PMID: 31662037.
  7. Turc G., Bhogal P., Fischer U. et al. European Stroke Organisation (ESO) — European Society for Minimally Invasive Neurological Therapy (ESMINT) Guidelines on Mechanical Thrombectomy in Acute Ischaemic StrokeEndorsed by Stroke Alliance for Europe (SAFE). Eur Stroke J. 2019; 4(1): 6–12. doi: 10.1177/2396987319832140. PMID: 31165090.
  8. Kretov E.I., Malaev D.U., Andreev M.N. et al. [Combined transcatheter thrombectomy system for treatment of acute ischaemic stroke]. Patologiya krovoobrashcheniya i kardiokhirurgiya. 2019; 23(4): 63–72. doi: 10.21688/1681-3472-2019-4-63-72. (In Russ.)
  9. Goyal M., Demchuk A.M., Menon B.K. et al. Randomized assessment of rapid endovascular treatment of ischemic stroke. N Engl J Med. 2015; 372(11): 1019–1030. doi: 10.1056/NEJMoa1414905. PMID: 25671798.
  10. Saver J.L., Goyal M., Bonafe A. et al. Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke. N Engl J Med. 2015; 372(24): 2285–2295. doi: 10.1056/NEJMoa1415061. PMID: 25882376.

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Copyright (c) 2021 Grachev N.I., Malaev D.U., Andreev M.N., Trebushat D.V., Syrovnev G.I., Loskutnikov M.A., Vakin T.M., Konstantinov V.I., Domashenko M.A.

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