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Small Profile Retriever Safely Salvages Intracranial Clots

By HospiMedica International staff writers
Posted on 15 Aug 2018
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Image: The Tigertriever 13 deployed in the distal pericallosal artery (Photo courtesy of Rene Chapot).
Image: The Tigertriever 13 deployed in the distal pericallosal artery (Photo courtesy of Rene Chapot).
An adjustable, fully visible clot retriever is designed to retrieve blood clots provoking medium vessel occlusion (MVO) in ischemic stroke patients.

The Rapid Medical (Yokneam, Israel) Tigertriever 13 thrombectomy system is intended to restore blood flow in intracranial vessels 1-2.5 mm in diameter, which form around 30% of MVOs found in ischemic stroke patients. The Tigertriever is composed of a fully recoverable, foldable wire structure made of nitinol that is mounted on a metal stem. The diameter of the mesh and the radial force on the vessel wall are mechanically adjustable using the delivery handle, thus allowing for optimal adaptability without causing stress to the vessel wall. The nitinol mesh is radiopaque for perfect visibility inside the vessels.

The system includes the handle and integrated slider, which controls mesh expansion, a locking-screw that sets the wire mesh at the selected diameter, and proximal and distal markers for confirming correct positioning of the mesh inside the vessel. Percutaneous delivery is via a neurovascular microcatheter with a soft distal outer diameter of 1.3Fr. At the end of the procedure, the mesh is removed, resulting in recanalization of the intracranial vessel. Another advantage is that it is not necessary to continue long-term antiplatelet therapy, as required in the case of stent implantation.

“Tigertriever 13 is a very important addition to the ischemic stroke device market. For the first time ever, we have a tool that is dedicated to more distal occlusions,” said Professor René Chapot, MD, head of radiology at Krupp Krankenhaus (Essen, Germany). “These occlusions can have a dramatic disabling effect on patients, and until now there was little to be done for them. Using the Tigertriever 13 we were able to retrieve clots from an MVO that was not treatable until now.”

Ischemic stroke is the most common type of stroke (85%), caused by an obstructed artery that supplies blood to the brain. For years, the gold-standard treatment was clot-busting tissue plasminogen activator (tPA), which works by dissolving the clot and improving blood flow to the section of brain being deprived of blood. However, it must be administered within four to six hours of the stroke, and is not effective in all cases.

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