Department of Neuroradiology, Otto-von-Guericke University Clinic, Magdeburg, Germany.
Department of Neuroradiology, University Hospital RWTH, Aachen, Germany.
Interv Neuroradiol. 2024 Apr;30(2):183-188. doi: 10.1177/15910199221118146. Epub 2022 Sep 15.
The ThrombX Retriever is a novel mechanical thrombectomy device that adjusts the distance between two mesh segments to axially hold thrombus. A post-market study assessed safety and performance in acute ischemic stroke patients with large artery occlusion.
A single-arm prospective multi-center study enrolled patients at 5 European Centers. Patients had a symptomatic large-artery occlusion of the intracranial Internal Carotid or the Middle Cerebral Artery, M1 segment. The primary outcome measure was the modified treatment in cerebral infarction (mTICI) score, on the immediate post-procedure angiogram after up to three device passes. Key secondary outcome measures were the mTICI score after a single pass and functional independence, defined as an mRS score ≤ 2 at 90 days.
Thirty patients (16 Females, mean age 72 years), with NIHSS 4-25 (mean 15.5) were treated. Twenty-eight (93%) achieved mTICI 2b-3 within 3 passes, and 24 (80%) were with the first pass (FP). FP mTICI 2c-3 reperfusion was achieved in 19 (63%) cases. Seventeen of 24 (71%) patients treated with a balloon guide and the ThrombX Retriever had a FP mTICI 2c-3 reperfusion. After all interventions, mTICI 2b-3 was seen in 30 (100%) patients. Twenty-one of the 29 (73%) patients with 90-day follow-up were functionally independent (mRS≤2). No device-related serious adverse events were observed.
This preliminary study suggests the ThrombX Retriever is safe and has a high rate of substantial reperfusion. A larger prospective trial to assess the device effectiveness is planned.
ThrombX 取栓器是一种新型机械取栓装置,可调节两个网片段之间的距离,从而轴向固定血栓。一项上市后研究评估了该装置在伴有大动脉闭塞的急性缺血性脑卒中患者中的安全性和性能。
一项单臂前瞻性多中心研究在欧洲 5 家中心入组患者。患者为症状性颅内颈内动脉或大脑中动脉 M1 段大动脉闭塞。主要终点是即刻术后血管造影时的改良脑梗死溶栓(mTICI)评分,最多进行 3 次取栓操作。主要次要终点是单次通过后的 mTICI 评分和功能独立性,定义为 90 天时 mRS 评分≤2。
30 例患者(16 例女性,平均年龄 72 岁),NIHSS 评分 4-25 分(平均 15.5 分),28 例(93%)在 3 次通过内达到 mTICI 2b-3,24 例(80%)为首次通过(FP)。19 例(63%)患者的 FP mTICI 2c-3 再通。24 例中,17 例(71%)接受球囊导管和 ThrombX 取栓器治疗的患者获得 FP mTICI 2c-3 再通。所有干预后,30 例(100%)患者的 mTICI 2b-3 达到。29 例中有 21 例(73%)患者在 90 天随访时功能独立(mRS≤2)。未观察到与器械相关的严重不良事件。
这项初步研究表明 ThrombX 取栓器安全且再通率高。计划进行更大规模的前瞻性试验以评估该器械的有效性。