Schwab Roland, Kis Balázs, Réka Berki Alexandra, Gellen Janos Sebestyen, Haider Katharina, Khadhraoui Eya, Müller Sebastian Johannes, Fuchs Erelle, Thormann Maximilian, Pfaff Johannes Alex Rolf, Behme Daniel
University Clinic for Neuroradiology, University Hospital Magdeburg, Magdeburg, Germany
Research Campus Stimulate, Otto von Guericke University Magdeburg, Magdeburg, Germany.
J Neurointerv Surg. 2025 May 20. doi: 10.1136/jnis-2025-023476.
Mechanical thrombectomy for the treatment of acute ischemic stroke has undergone relevant technical improvements over recent years. However, distal emboli and incomplete reperfusion after mechanical thrombectomy are still shortcomings in the care of patients with endovascular acute ischemic stroke. The NeVa NET 5.5 thrombectomy device (Vesalio, Nashville, Tennessee, USA) is the first stent retriever featuring an integrated clot micro-filtration system, aiming to enhance first pass efficacy and reduce distal embolization. This study evaluates the safety and efficacy of the NeVa NET 5.5 thrombectomy device.
Patients with acute anterior circulation occlusions and vessel diameters >2 mm treated with the NeVa NET 5.5 stent retriever as a first-line approach were retrospectively included in this study. Data were collected from three European comprehensive stroke centers between October 2022 and April 2024. Patient data, occlusion details, clinical outcomes, and procedure-related parameters were analyzed.
A total of 51 patients were included. The most common occlusion locations were the internal carotid artery terminus and intradural internal carotid artery (70.6%). The mean±SD clot length was 25.1±13.3 mm (range 4-50 mm). First pass reperfusion (eTICI 2b-3) was achieved in 78.5%, with a final reperfusion rate of eTICI 2b-3 in 98.1%. Distal embolization in new territories occurred in 3.9%. No device-related adverse events were reported, and procedure-related adverse events occurred in 7.6% of the overall included cases.
The NeVa NET 5.5 stent retriever has a high first pass reperfusion rate in large vessel occlusions of the anterior circulation, with a good safety profile and low rate of distal embolization.
近年来，用于治疗急性缺血性卒中的机械取栓术在技术上有了相关改进。然而，机械取栓术后的远端栓子和再灌注不完全仍是血管内治疗急性缺血性卒中患者时存在的不足。NeVa NET 5.5取栓装置（美国田纳西州纳什维尔市的Vesalio公司生产）是首款配备集成式血栓微滤系统的支架取栓器，旨在提高首次通过效率并减少远端栓塞。本研究评估了NeVa NET 5.5取栓装置的安全性和有效性。
本研究回顾性纳入了以NeVa NET 5.5支架取栓器作为一线治疗方法、患有急性前循环闭塞且血管直径>2毫米的患者。数据收集于2022年10月至2024年4月期间的三个欧洲综合性卒中中心。对患者数据、闭塞细节、临床结局和手术相关参数进行了分析。
共纳入51例患者。最常见的闭塞部位是颈内动脉末端和硬脑膜内颈内动脉（70.6%）。平均±标准差的血栓长度为25.1±13.3毫米（范围4 - 50毫米）。首次通过再灌注（eTICI 2b - 3级）率为78.5%，最终eTICI 2b - 3级再灌注率为98.1%。新区域出现远端栓塞的比例为3.9%。未报告与装置相关的不良事件，在总体纳入病例中，与手术相关的不良事件发生率为7.6%。
NeVa NET 5.5支架取栓器在前循环大血管闭塞中具有较高的首次通过再灌注率，安全性良好，远端栓塞率低。
