In-vitro testing of RF-enabled low force mechanical thrombectomy for ischemic stroke

Chon, Chi Hang; Qin, Zhen; Lam, Alexander Kn; Kwok, John Ching Kwong; Yuen, Matthew Mf; Lam, David Chuen Chun

doi:10.1109/embc.2015.7318618

Cited by 5 publications

(6 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is well-known that high radial force is associated with higher rates of clot removal (34). However, high radial force is also associated with endothelial vessel wall injury (35,36). Therefore, minimizing radial force may reduce the incidence of vessel wall injury complications while still maintaining optimal clot retrieval rates.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of a Novel Thrombectomy Device in Patients With Acute Ischemic Stroke: A Randomized Controlled Trial

Zhang

Hua

et al. 2021

Front. Neurol.

View full text Add to dashboard Cite

Purpose: The Tonbridge stent is a novel retriever with several design improvements which aim to achieve promising flow reperfusion in the treatment of acute ischemic stroke (AIS). We conducted a randomized controlled, multicenter, non-inferiority trial to compare the safety and efficacy of the Tonbridge stent with the Solitaire FR.Methods: AIS patients aged 18–85 years with large vessel occlusion in anterior circulation who could undergo puncture within 6 h of symptom onset were included. Randomization was performed on a 1:1 ratio to thrombectomy with either the Tonbridge stent or the Solitaire FR. The primary efficacy endpoint was successful reperfusion using a modified thrombolysis in cerebral infarction score (mTICI) of 2b/3. Safety outcomes were symptomatic intracranial hemorrhage (sICH) within 24 ± 6 h and all-cause mortality within 90 days. A clinically relevant non-inferiority margin of 12% was chosen as the acceptable difference between groups. Secondary endpoints included time from groin puncture to reperfusion, National Institutes of Health Stroke Scale (NIHSS) score at 24 h and at 7 days, and a modified Rankin Scale (mRS) score of 0–2 at 90 days.Results: A total of 220 patients were enrolled; 104 patients underwent thrombectomy with the Tonbridge stent and 104 were treated with the Solitaire FR. In all test group patients, the Tonbridge was used as a single retriever without rescuing by other thrombectomy devices. Angioplasty with balloon and/or stent was performed in 26 patients in the Tonbridge group and 16 patients in the Solitaire group (p = 0.084). Before angioplasty, 86.5% of those in the Tonbridge group and 81.7% of those in the Solitaire group reached successful reperfusion (p = 0.343). Finally, more patients in the Tonbridge group achieved successful reperfusion (92.3 vs. 84.6%, 95% CI of difference value 0.9–16.7%, p < 0.0001). There were no significant differences on sICH within 24 ± 6 h between the two groups. All-cause mortality within 90 days was 13.5% in the Tonbridge group and 16.3% in the Solitaire group (p = 0.559). We noted no significant differences between groups on the NIHSS at either 24 h or 7 days and the mRS of 0–2 at 90 days.Conclusion: The trial indicated that the Tonbridge stent was non-inferior to the Solitaire FR within 6 h of symptom onset in cases of large vessel occlusion stroke.Clinical Trial Registration:ClinicalTrials.gov, number: NCT03210623.

show abstract

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of a Novel Thrombectomy Device in Patients With Acute Ischemic Stroke: A Randomized Controlled Trial

Zhang

Hua

et al. 2021

Front. Neurol.

View full text Add to dashboard Cite

show abstract

“…Wenger et al proposed a vascular glass model to evaluate the efficacy of the stent retriever design [ 20 ]. Chon et al used a transparent Tygon tube to simulate a blood vessel in their in vitro testing [ 9 ]. In our study, a transparent acrylic tube, similar to Liebig’s model, was used, and the retrieval process could be observed and recorded easily.…”

Section: Discussionmentioning

confidence: 99%

“…For example, peripheral stents are perhaps the most celebrated application of the Nitinol material. They are crush recoverable and more physiologically compatible than balloon-expandable stents in many indications such as carotid, superficial femoral, popliteal, and iliac arteries [ 7 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…Several recent retriever studies from academia have proposed different concepts in designs and materials. Chon et al built a retriever prototype using localized radio frequency (RF) to perform blood clot engagement with minimal stenting force [ 9 ]. Muschenborn et al evaluated the feasibility of utilizing shape memory polymer (SMP) acrylates for a retriever device through FEA modeling [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Due to its unique geometry, our designed stent retriever can engage with blood clots to achieve the highest blood clot removal rate. In this study, the development of the novel blood clot retriever was evaluated by finite element analysis [ 13 , 14 ], laser manufacturing, and in vitro clot retrieval tests [ 9 ]. The finite element models were developed to analyze the mechanical behavior and manufacturing feasibility of the devices.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Novel Blood Clot Retriever for Ischemic Stroke

et al. 2021

View full text Add to dashboard Cite

Stroke is the second leading cause of death in the world. Ischemic stroke, caused by the blockage of intracranial arteries, accounts for approximately 80% of strokes. Among this proportion, acute ischemic stroke, usually caused by the sudden formation of blood clots, can cause fatal blockages in arteries. We proposed a unique blood clot retriever for the treatment of acute ischemic stroke, and conducted a series of tasks, including design, computer simulation, prototyping, and bench testing, for the proof of concept. Unlike most blood clot retrievers used today, our novel design deviates from traditional stent-like blood clot retrievers and uses large closed cells, irregular spikes, and strut protrusions to achieve maximum entanglement for better retrieval performance. Experimental results showed that the retrieval rate of our blood clot retriever was 79%, which demonstrated the feasibility of our new design concept.

show abstract

Characterization of thrombus stiffening in radio frequency (rf Mechanical thrombectomy

Chon

Qin

Kwok

et al. 2016

2016 38th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC)

View full text Add to dashboard Cite

Intra-arterial mechanical thrombectomy (IAMT) for ischemic stroke has high recanalization rate, long treatment time window and low risk of symptomatic intracerebral haemorrhage (sICH), but thrombus fragments produced during treatment can lead to distal embolization. Fragmentation can be reduced if the thrombus is strengthened by increasing the thrombus's crosslink density. Radio frequency (rf) electric current commonly used in surgery to cut and coagulate tissue can induce crosslinking in thrombus. The increase in thrombus stiffness as a result of the increase in crosslinking from rf treatment is characterized in this study. Test results showed that the stiffness of thrombus is increased by more than 8 times after rf treatment. The dramatic increase in stiffness suggests that thrombus fragmentation and distal embolization can be reduced by applying rf during thrombectomy treatment.

show abstract

In-vitro testing of RF-enabled low force mechanical thrombectomy for ischemic stroke

Cited by 5 publications

References 14 publications

Efficacy and Safety of a Novel Thrombectomy Device in Patients With Acute Ischemic Stroke: A Randomized Controlled Trial

Efficacy and Safety of a Novel Thrombectomy Device in Patients With Acute Ischemic Stroke: A Randomized Controlled Trial

Novel Blood Clot Retriever for Ischemic Stroke

Characterization of thrombus stiffening in radio frequency (rf Mechanical thrombectomy

Contact Info

Product

Resources

About