Mechanical Thrombectomy in Acute Ischemic Stroke: Catch Device

Abstract

BACKGROUND AND PURPOSE:Mechanical thrombectomy presents today a promising alternative to traditional stroke therapies. Our aim with this study was to evaluate the safety and efficacy of the Catch mechanical thrombectomy device in the treatment of acute stroke and report the angiographic results and clinical outcomes.

Safety and Efficacy of Endovascular Sonolysis Using the EkoSonic Endovascular System in Patients with Acute Stroke

“…Favorable clinical outcome (defined as mRS, 0 -2) ranged from 36% up to 74%. [10][11][12][13][14][15][16][17][18][19] The present study showed that the prevalence of recanalization and favorable outcome in patients treated by endovascular sonolysis in combination with local or systemic thrombolysis (and cPTAS if indicated) was comparable with (or even superior to) other endovascular methods, especially in patients with MCA occlusion. Moreover, it seemed to be safer.…”

“…In addition to pharmacologic methods, especially IV thrombolysis and intraarterial thrombolysis, mechanical neurointerventional methods ( [10][11][12][13][14][15][16][17][18][19] One of these, the EkoSonic Endovascular System, is the first tool system approved by the FDA that allows local endovascular application of high-frequency (2 MHz) and low-power (400 W/cm 2 ) sonography in clinical practice with or without simultaneous catheter-directed thrombolysis by application of thrombolytic drugs. [22][23][24] Several in vitro, in vivo, and clinical studies have shown the potential effect of sonography (sonolysis) to accelerate clot lysis.…”

“…5 The options for acceleration of recanalization of intracranial artery occlusion are the following: IV thrombolysis, IAT, or combined thrombolysis; mechanical recanalization by using several mechanical devices for thrombectomy and/or stent placement; and remote or local sonolysis. [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] Endovascular sonolysis can be used to accelerate and achieve recanalization of intracranial arterial occlusion. [22][23][24] The aim of the present study was to confirm the safety and efficacy of endovascular sonolysis by using the EkoSonic Endovascular System (EKOS, Bothell, Washington) in patients with acute ischemic stroke with occlusion of the middle cerebral artery or basilar artery within 8 hours after stroke onset.…”

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“…The CATCH device (Balt Extrusion, Montmorency, France) is a self expanding nitinol basket used to retrieve thrombi using a distal approach [29]. The Solitire FR (Ev3, California, USA), FDA approved in 2012, comprises of a retrievable stent (stentriever) that promotes restoration of blood flow by providing radial force to open and restore occluded vessels simultaneously allow administration of adjunctive medical therapy and retrieve clots via an open ended basket [30,31].…”

Inter- and Intraobserver Agreement in Scoring Angiographic Results of Intra-Arterial Stroke Therapy

“…A gamut of methods and devices has been introduced to accomplish revascularization. [1][2][3][4] While all may agree that the well-being of the patient at the end of treatment is the most important outcome, 5 we also need surrogate markers of mechanistic efficacy, directly linked to the effect we are aiming for, to more expediently determine which method or device should be selected to be tested in a more rigorous fashion, because the heterogeneity of presentations ensures that large trials will be needed to show differences in clinical outcomes. In addition, regulatory agencies approve devices according to their ability to restore blood flow.…”