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the trevo device: preclinical data of a novel stroke thrombectomy device in two different animal models of arterial thrombo-occlusive disease

by:Dolight LED Panel     2019-09-19
Abstract background at present, mechanical equipment available cannot be re-opened in up to 20-40% of the near-segment arterial occlusion stroke.
Objective to report a pre-clinical evaluation of the safety and effectiveness of a new thrombosis removal device designed to achieve immediate blood flow recovery by quickly removing blood clots.
Methods four confirmed animal studies were carried out with the Trevo device (
Tongxin Medical, Mountain View, California, USA)in the swine (n=2)and canine (n=1)
Model of arterial thrombosis
Occlusion of thrombosis caused by the use of autologous thrombosis.
To evaluate the angiography reaction and the degree of blood clot incorporation in the device.
High resolution flat screen TV
3D CT was performed to further determine the device-thrombosis-vascular interaction in vivo.
Finally, three pig vascular samples treated with the six channels of the device were explained for tissue pathology analysis.
Results in a variety of vascular environments, including pigs, a total of 16 blood clots with variable hardness and consistency were implanted, tongue, anterior limb artery, and external and spinal arteries of the dog.
Thrombolysis treatment of myocardial infarctionTIMI)
After the device is deployed, 2-3 re-perfusion is achieved in all cases immediately.
Take out all 16 blood clots after 1 time (n=15)or two (n=1)
Pass with the equipment.
Pathological analysis showed serious rupture of the endometrium but no membrane or outer membrane bleeding.
Conclusion experimental data show that the Trevo device is very effective in achieving immediate re-perfusion of the occlusion artery without causing any significant clinical disruption of vascular integrity.
Background currently available mechanical devices cannot be re-opened in as many as 20-40% of near-segment arterial occlusion strokes.
Objective to report a pre-clinical evaluation of the safety and effectiveness of a new thrombosis removal device designed to achieve immediate blood flow recovery by quickly removing blood clots.
Methods four confirmed animal studies were carried out with the Trevo device (
Tongxin Medical, Mountain View, California, USA)in the swine (n=2)and canine (n=1)
Model of arterial thrombosis
Occlusion of thrombosis caused by the use of autologous thrombosis.
To evaluate the angiography reaction and the degree of blood clot incorporation in the device.
High resolution flat screen TV
3D CT was performed to further determine the device-thrombosis-vascular interaction in vivo.
Finally, three pig vascular samples treated with the six channels of the device were explained for tissue pathology analysis.
Results in a variety of vascular environments, including pigs, a total of 16 blood clots with variable hardness and consistency were implanted, tongue, anterior limb artery, and external and spinal arteries of the dog.
Thrombolysis treatment of myocardial infarctionTIMI)
After the device is deployed, 2-3 re-perfusion is achieved in all cases immediately.
Take out all 16 blood clots after 1 time (n=15)or two (n=1)
Pass with the equipment.
Pathological analysis showed serious rupture of the endometrium but no membrane or outer membrane bleeding.
Conclusion experimental data show that the Trevo device is very effective in achieving immediate re-perfusion of the occlusion artery without causing any significant clinical disruption of vascular integrity.
Four confirmed animal studies (
Three equipment performance;
Pathology 1)
Perform using a Trevo device (
Tongxin Medical, Mountain View, California, USA)in swine (n=2)and canine (n=1)
Model of arterial thrombosis
Occlusion disease using autologous thrombosis produces different consistent clots from five different operators, as shown below.
Device Description the Trevo device is designed to remove the occlusion thrombosis in the AIS settings in the blood vessel, ranging from 1. 5 to 3.
Diameter 5mm.
The device consists of a proximal 0 of a cm.
018 inch core line with 75 cm conical transition and closed cell scaffold-
Part of the shape of the far end (figure 1).
The total length of the device is 44mm and the diameter is 4mm.
The distal end has a soft non-directional radiation opaque tip of 4mm, designed to be deployed safely and accurately, and to facilitate the visualization of fluorescent perspective.
The far end 10mm of the device is tapered, allowing a smooth transition from the soft floppy disk ray opaque tip to the higher radial force active area of the device, it is allowed to be placed in more distal and smaller vessels.
The nearly 10mm of the unit is also tapered for easy re-sheath.
The Trevo device has a hydrophilic coating to reduce friction during use.
Axis marks indicate the degree of proximity of the device to the tip of the micro-guide tube.
The direction of the stent pillar is different from the typical direction of the stent used for the treatment of the aneurysm (neck bridging)
Or cranial artery porridge
In these devices, in order to optimize coverage and wall installation, a wider part of struts is in contact with the vessel wall.
In the Trevo device, the wider part of struts has internal orientation in order to optimize the integration of thrombosis.
Download the device for the new tabDownload figureOpen powerpointFigure month Trevo.
In addition, the device is designed to have a more constant radial force on the expected vessel diameter.
These features are expected to lead to consistent and effective lumps incorporation and recyclability.
The clot size of the thrombosis model ranges from 3 to 4mm and the length ranges from 10 to 15mm.
Using autologous whole blood incubated with different levels of bovine coagulation to make a clot with different mechanical stiffness (
0-8 cow blood/ml)and barium (
1-2 µg/10 ml blood)concentrations.
A white clot was also prepared using platelet-rich plasma isolated from autologous whole blood.
Platelet-rich plasma and bovine coagulation (
Plasma 8 nihu/ml)and barium (
1 µg/10 µml plasma).
As described below, clot fragments are selectively introduced into the target vascular system. This radio-
Opaque thrombosis models allow the authors to evaluate thrombosis fragments and/or distal embolism during the passage, deployment and recovery of the device, as previously described by Gralla and colleagues.
6 animal models, procedural techniques and results measurement all procedures are approved by the local Institutional Care and Use Committee and are carried out in accordance with the guidelines set out in the Animal Welfare Act (
Three Yorkshire pigs weighing about 30 kilograms and a hybrid dog weighing about 20 kilograms were used.
In all cases, the anesthesia was maintained with oxygen mechanical ventilation containing 2% of the total.
Gansu pill (100u2005U/kg)
Intravenous administration is maintained at 500 U per hour, and the coagulation time to maintain activation is more than 250.
The femoral artery channel was then obtained and the 8f guide catheter was obtained (
Dog Model 6 F)
Place in the target container with 0.
035 inch hydrophilic silk.
For efficacy analysis, 16 different concentrations of thrombosis were injected into the guide catheter through the syringe and the distal end was allowed to be embolized into the inner jaw of the pig (IMA, n=6), lingual (n=3)and forelimb (n=4)
Arteries and external cervical arteries of dogs (n=1)and vertebral (n=2)arteries.
Thrombosis is allowed to mature in at least 30 minutes.
The diameter of the target vessel is between 2 and 3.
5mm, the same size as in the human brain, the basal artery, and the distal cranial artery.
Vascular occlusion was confirmed by digital subtraction angiography and thrombolysis assessment of myocardial infarction (TIMI)
Traffic level of 0 or 1 (
Continuous occlusion or trickle). 7 A 2.
5 F MC18 Plus micro guide tube (
Tongxin Medical Company
Navigate on 0.
014 micro line through the occlusion of thrombosis.
Take out the wire and compare the micro-guide tube to confirm the cavity position of the distal end of the occlusion.
The Trevo device is then pushed into a micro-guide tube that spans the full length of the occlusion thrombosis.
Then, deploy the Trevo device by slowly retracting the micro-guide, while keeping the constant forward tension on the Trevo push wire.
The sheath-free radial of the device replaces the thrombosis to the vessel wall, thereby immediately restoring blood flow.
Guided catheter angiography was performed to assess the extent of re-perfusion.
Then a thrombosis recovery attempt was made within 60 µs after deployment by slowly withdrawing the Trevo device and the micro-guide tube as a unit under the guidance of the fluorescent mirror.
At this point, suction is performed using a 60 ml syringe without any flow stagnation (
Balloon guide catheter not used).
Control angiography was performed after each passing of the device to assess the degree of re-opening according to the TIMI scale (
Main results).
In addition, the extent of the incorporation of the device-blood clot was assessed by a macroscopic examination of the device and the recovered thrombosis.
Finally, a high-resolution tablet three
Size CT constructed from 610 projected images obtained by 200 ° arc (
Best Philips healthcare company in the Netherlands)
Performed with a device deployed on the thrombosis of the tongue artery occlusion of the pig to further define the in vivo device-thrombosis-vascular interaction.
For safety analysis, the Trevo device is deployed to the right IMA of the pig through the MC18 Plus micro-guide tube (diameter 3. 0u2005mm)
Right ascending artery (APA 2. 4u2005mm)and left APA (2. 2u2005mm)
Then retract as a system, six times on each ship.
At the end of the operation, animals were executed and tissue samples of the treated blood vessels were collected.
The specimens were subjected to tissue pathology analysis, including the staining of semen Sumi-ihong and elastic protein (
Pentecost)stain.
In order to assess the extent of arterial injury, ordered data of multiple parameters were collected to include (1)
Loss of endothelial cells ,(2)
Platelet/fib on the surface of the exposed lumen ,(3)
Media bleeding ,(4)
Seventh-day bleeding of Christ5)
Medial injury using a semi-quantitative scoring system (table 1).
Values are calculated for each part and level and reported as the overall mean for each vessel, ranging from 0 (no injury)to 20 (
Most likely damage).
In another safety assessment test, the device was deployed in the canine basal artery to assess any evidence of angiography of minor vascular injuries (1. 5u2005mm diameter)
Thin-walled container.
View this table: View semi-quantitative analysis of vascular tissue pathology changes handled by inline View popupTable 1 with Trevo equipment description the Trevo device was designed to remove occlusion thrombosis in the vascular AIS environment5 to 3.
Diameter 5mm.
The device consists of a proximal 0 of a cm.
018 inch core line with 75 cm conical transition and closed cell scaffold-
Part of the shape of the far end (figure 1).
The total length of the device is 44mm and the diameter is 4mm.
The distal end has a soft non-directional radiation opaque tip of 4mm, designed to be deployed safely and accurately, and to facilitate the visualization of fluorescent perspective.
The far end 10mm of the device is tapered, allowing a smooth transition from the soft floppy disk ray opaque tip to the higher radial force active area of the device, it is allowed to be placed in more distal and smaller vessels.
The nearly 10mm of the unit is also tapered for easy re-sheath.
The Trevo device has a hydrophilic coating to reduce friction during use.
Axis marks indicate the degree of proximity of the device to the tip of the micro-guide tube.
The direction of the stent pillar is different from the typical direction of the stent used for the treatment of the aneurysm (neck bridging)
Or cranial artery porridge
In these devices, in order to optimize coverage and wall installation, a wider part of struts is in contact with the vessel wall.
In the Trevo device, the wider part of struts has internal orientation in order to optimize the integration of thrombosis.
Download the device for the new tabDownload figureOpen powerpointFigure month Trevo.
In addition, the device is designed to have a more constant radial force on the expected vessel diameter.
These features are expected to lead to consistent and effective lumps incorporation and recyclability.
The clot size of the thrombosis model ranges from 3 to 4mm and the length ranges from 10 to 15mm.
Using autologous whole blood incubated with different levels of bovine coagulation to make a clot with different mechanical stiffness (
0-8 cow blood/ml)and barium (
1-2 µg/10 ml blood)concentrations.
A white clot was also prepared using platelet-rich plasma isolated from autologous whole blood.
Platelet-rich plasma and bovine coagulation (
Plasma 8 nihu/ml)and barium (
1 µg/10 µml plasma).
As described below, clot fragments are selectively introduced into the target vascular system. This radio-
Opaque thrombosis models allow the authors to evaluate thrombosis fragments and/or distal embolism during the passage, deployment and recovery of the device, as previously described by Gralla and colleagues.
6 animal models, procedural techniques and results measurement all procedures are approved by the local Institutional Care and Use Committee and are carried out in accordance with the guidelines set out in the Animal Welfare Act (
Three Yorkshire pigs weighing about 30 kilograms and a hybrid dog weighing about 20 kilograms were used.
In all cases, the anesthesia was maintained with oxygen mechanical ventilation containing 2% of the total.
Gansu pill (100u2005U/kg)
Intravenous administration is maintained at 500 U per hour, and the coagulation time to maintain activation is more than 250.
The femoral artery channel was then obtained and the 8f guide catheter was obtained (
Dog Model 6 F)
Place in the target container with 0.
035 inch hydrophilic silk.
For efficacy analysis, 16 different concentrations of thrombosis were injected into the guide catheter through the syringe and the distal end was allowed to be embolized into the inner jaw of the pig (IMA, n=6), lingual (n=3)and forelimb (n=4)
Arteries and external cervical arteries of dogs (n=1)and vertebral (n=2)arteries.
Thrombosis is allowed to mature in at least 30 minutes.
The diameter of the target vessel is between 2 and 3.
5mm, the same size as in the human brain, the basal artery, and the distal cranial artery.
Vascular occlusion was confirmed by digital subtraction angiography and thrombolysis assessment of myocardial infarction (TIMI)
Traffic level of 0 or 1 (
Continuous occlusion or trickle). 7 A 2.
5 F MC18 Plus micro guide tube (
Tongxin Medical Company
Navigate on 0.
014 micro line through the occlusion of thrombosis.
Take out the wire and compare the micro-guide tube to confirm the cavity position of the distal end of the occlusion.
The Trevo device is then pushed into a micro-guide tube that spans the full length of the occlusion thrombosis.
Then, deploy the Trevo device by slowly retracting the micro-guide, while keeping the constant forward tension on the Trevo push wire.
The sheath-free radial of the device replaces the thrombosis to the vessel wall, thereby immediately restoring blood flow.
Guided catheter angiography was performed to assess the extent of re-perfusion.
Then a thrombosis recovery attempt was made within 60 µs after deployment by slowly withdrawing the Trevo device and the micro-guide tube as a unit under the guidance of the fluorescent mirror.
At this point, suction is performed using a 60 ml syringe without any flow stagnation (
Balloon guide catheter not used).
Control angiography was performed after each passing of the device to assess the degree of re-opening according to the TIMI scale (
Main results).
In addition, the extent of the incorporation of the device-blood clot was assessed by a macroscopic examination of the device and the recovered thrombosis.
Finally, a high-resolution tablet three
Size CT constructed from 610 projected images obtained by 200 ° arc (
Best Philips healthcare company in the Netherlands)
Performed with a device deployed on the thrombosis of the tongue artery occlusion of the pig to further define the in vivo device-thrombosis-vascular interaction.
For safety analysis, the Trevo device is deployed to the right IMA of the pig through the MC18 Plus micro-guide tube (diameter 3. 0u2005mm)
Right ascending artery (APA 2. 4u2005mm)and left APA (2. 2u2005mm)
Then retract as a system, six times on each ship.
At the end of the operation, animals were executed and tissue samples of the treated blood vessels were collected.
The specimens were subjected to tissue pathology analysis, including the staining of semen Sumi-ihong and elastic protein (
Pentecost)stain.
In order to assess the extent of arterial injury, ordered data of multiple parameters were collected to include (1)
Loss of endothelial cells ,(2)
Platelet/fib on the surface of the exposed lumen ,(3)
Media bleeding ,(4)
Seventh-day bleeding of Christ5)
Medial injury using a semi-quantitative scoring system (table 1).
Values are calculated for each part and level and reported as the overall mean for each vessel, ranging from 0 (no injury)to 20 (
Most likely damage).
In another safety assessment test, the device was deployed in the canine basal artery to assess any evidence of angiography of minor vascular injuries (1. 5u2005mm diameter)
Thin-walled container.
View this table: View the semi-quantitative analysis of vascular tissue pathology changes treated with Trevo device eresultsa in inline View popupTable 1 implanted 16 hardness in various vascular environments as described above.
TIMI 2-3 re-perfusion in all blood vessels immediately after device deployment (figure 2A,B).
There is no evidence of angiography for anatomy, contrast exfiltration or thrombosis, but most of the manipulated pig blood vessels have different degrees of spasm throughout the process.
This occurs during the operation of the guide conduit, wire and micro-guide tube, but is more important after the recovery device.
In general, dogs have a much lighter degree of spasm than pig models.
Part of the radio.
In some cases, opaque lumps are found after the micro-guide pipe crosses and/or the device is deployed, but in all cases the device will be in one (n=15)or two (n=1)
Treatment of cerebral infarction by leading to 100% TIMI/thrombolysis (TICI)
3 flow re-perfusion rate (figure 2C,D).
In the case that two devices are required to pass, during the initial passage, a small piece of soft clot is lost at the branch of the blood vessel, resulting in incomplete re-perfusion (TIMI/TICI 2).
This small fragment is easily retrieved during the second pass, resulting in the TIMI/TICI 3 stream.
Otherwise, the thrombosis-device interaction in the retrieval process seems to be related to the post-
In the deployment state, there is no significant additional fragmentation, stretching or compression of the thrombosis until the tip of the guide catheter is reached.
When returning to the guide catheter under suction, there are some additional fragments at the tip of the guide catheter, but no thrombosis is lost.
The macroscopic inspection of the device and the recovered thrombosis material shows that the device contains a clot of soft and hard consistency (figure 3A,B).
High-resolution flat-panel CT examination also appreciates the incorporation of the clot in the body of the device (figure 4A,C).
Figure 2 example of immediate stream recovery (A, B)
And thrombosis recovery (C, D). (A)
Pretreatment angiography of the right tongue artery of the pig.
Black Arrow: point of complete occlusion (
Thrombolysis treatment of myocardial infarctionTIMI)
Thrombolysis treatment of cerebral infarction (TICI)0 flow).
White Arrow: less opaque thrombosis of the ray. (B)
The TIMI/TICI 3 stream was implemented immediately after the deployment of the Trevo device.
Arrow: Near side (black)and distal (white)
Ray opaque marking of the Trevo device.
Black Arrow: Tip of micro guide tube.
White Arrow: residual narrow areas due to the presence of thrombosis. (C)
Pre-treated angiography of the left upper internal artery of the pig.
Arrow: point of complete occlusion (
TIMI/TICI 0 traffic).
Arrow: subtract the opaque thrombosis of the ray. (D)
The TIMI/TICI 3 stream was implemented immediately after retrieving the Trevo device.
Arrow: complete re-opening of the internal maxilla artery without residual stenosis.
Download the device of the new tabDownload figureOpen powerpointFigure month to set up a joint stock limited company-clot soft (A)and hard (B)thrombi (arrows).
Download an example of the device-clot-vascular interaction in figure 4 in vivo in the new tabDownload powerpoint. (A)
Road map of left tongue angiography in pigs. (B)
High resolution flat panel CT III
3D reconstruction.
Arrow: Near side (black)and distal (white)
Ray opaque marking of the Trevo device.
Arrow: Ray opaque thrombosis. (C)
Axial cutting reconstruction of the determined area (B)
The arrow shows the complete incorporation of radiation opaque thrombosis (arrowhead)
Struts through the Trevo device.
Pathological analysis was performed in three external branches of the neck of pigs, with a range of 2.
2 to 3mm in diameter.
Five sections were analyzed on each ship, each with six levels, with a total of 90 levels.
Basically, the endometrium is severely cracked, but there is no middle/outer membrane bleeding, and there is no evidence of extensive arterial damage consisting of medial anatomy across the wall (
Tear or puncture)(figure 5).
Specifically, the average injury score for right IMA was 4 points.
3 out of 20 people, with very little/focal protein/platelet deposition due to severe endothelial loss, and very little Focal disruption in the internal elastic leaves (IEL).
The average injury score for right APA was 4.
5 out of 20, due to moderate to severe loss of endothelial cells, occasional focal areas of IEL or widespread disruption.
The average injury score for APA on the left side was 4.
2 of the 20 people were due to severe loss of endothelial cells, rare local fib/platelet deposition regions and rare IEL disruption regions.
Download figureOpen in the new tabDownload powerpoint figure 5 the right side of the swallow-ascending artery section of Sumu-ihong staining microphotography shows the loss of endothelial cells (blue arrows).
This is the most common pathological finding in this study.
In the absence of any technical difficulties, the Trevo device is navigated to the basal artery of the dog.
As expected, the deployment/retrieval of the device will lead to serious self-
Restricted spasm of the basal artery, but no evidence of angiography of arterial dissection, perforation, rupture or thrombosis.
Discussion we report experimental data supporting the safety and effectiveness of the Trevo device, a new mechanical device for the treatment of AIS patients.
The Trevo device belongs to a new class of thrombosis removal devices, which are increasingly referred to as \"stentrievers\" due to its similarity with the cranial stent \".
Compared with the current approach, this new technology has several theoretical advantages.
The use of a cranial stent in AIS is associated with rapid flow recovery and high re-pass rates.
However, this technique is limited by the need for active anti-thrombosis treatment protocols to avoid acute inpatient treatment
In the AIS environment, stent thrombosis significantly increases the risk of bleeding complications.
Another important limitation of the use of cranial stent in AIS is that, unlike acute coronary syndrome, in acute coronary syndrome, the rupture of potential coronary plaque is the most common offender, most cases of acute cranial artery occlusion were associated with embolus without any in situ vascular pathology.
In this case, placing a permanent implant may create an additional incidence without any advantage over removing the thrombosis.
The idea of using a bracket or bracket-
A device like a clot finder is not novel.
Neural network equipment (
Santa Clara Jidan, California, USA)
It is a laser-cut nickel-titanium alloy basket based on microguide wire, which is very similar to the closed cell scaffold attached to the forming platinum tip wire.
The device could be the first generation of \"stentrievers\" and has shown very promising results nearly a decade ago.
9-11 unfortunately, a large clinical trial of the planned neural network device has never been completed and is no longer available.
The idea of using a closed cell scaffold (
For example, companies in the United States, reinam, Goldman and shukff)
Subsequently, methods for the removal of blood clots or foreign bodies were tested in vitro and in vivo models, which confirmed the high potential of this method.
12 Finally, the Solitaire AB device originally conceptualized as a bridging stent for the neck of the aneurysm has been used for non-
The labeling method acts as a thrombosis removal device and proves the non-parallel speed of the re-perfusion and re-circulation rate.
This has resulted in a number of minor design changes to produce Solitaire FR devices currently being CE-marked for AIS treatment in Europe.
The \"Stentrievery\" concept retains all the major advantages of cranial stent surgery, including immediate flow recovery and the possibility of using an assisted internal stent
Arterial drug therapy to dissolve the surrounding displaced thrombosis, however, it also overcomes most of the limitations of stent use, eliminating the need for postoperative anti-thrombosis therapy and the risk associated with long-term implantation.
In addition, this method allows the removal of the clot quickly and reliably, at least in theory, should reduce the chance of early vascular Reformation
Occlusion compared to drugs and other mechanical methods such as thrombosis rupture, vascular prototyping, and stent surgery.
Our findings are in complete agreement with these concepts: In the absence of any early evidence of re-perfusion, we have achieved a 100% re-perfusion rateocclusion.
Stentrievers also has potential advantages over many of the currently available thrombosis removal devices.
Compared to other devices, such as Merci devices with a more fixed diameter, stentrievers gradually expand the diameter as they are withdrawn into the guide catheter through larger cranial and neck vessels at a closer end, so they oppose blood vessels throughout the removal process.
This prevents the removal of the thrombosis from the device and re-
Embolism of cerebral vessels.
As a result, they may not need to use a balloon-guided catheter for near-segment vascular occlusion, a step that usually increases the time and technical challenge for thrombosis.
Our study carries animal models that do not fully reproduce all the limitations inherent in the challenges faced by humans.
Although the diameter of the blood vessels treated in our study is quite consistent with that of the human cranial arteries, neither the model of dogs nor pigs can simulate the same degree of distortion encountered in the human cerebral vessels.
Another limitation of pig models is their aggressive coagulation system, which does not represent humans.
Therefore, it is useful to provide anti-coagulation agent 15 or anti-platelet 16 treatment in this model system during the assessment of thrombosis.
Using an anti-coagulation agent in our study may prevent
Occlusion in device-related endothelial injury settings.
Although we tested a variety of blood clot consistency, we are unlikely to mimic the various situations that may occur during a human stroke.
In addition, the histological features of our thrombosis model are not necessarily consistent with the recovered thrombosis embolus in stroke patients.
However, we have addressed a major issue related to the use of stentrievers: the theoretical risk of clinically significant vascular injury caused by \"dragging deployed stent\" through cerebral vessels.
We solved this problem in the current study by performing a detailed pathological analysis of the treated blood vessels.
Histological findings were found to be within the range of vascular-like surgery, and no obvious adverse problems were attributed to the Trevo device.
In this regard, there is little literature on the risk of vascular injury following the use of a stroke thrombosis removal device.
Jahan reported the performance comparison of the solitaire blood transport reconstruction device (
Irvine ev3, California, USA)
Compared with the Merci Retrieval System (
Tongxin Medical Company)
Restore the blood flow of the common and ascending arteries of the pig.
17 The Solitaire unit resumes flow immediately after deployment in five of the six containers and recycles the clot, resulting in three of the six containers in six containers flowing.
The Merci device implements TIMI 2 flow in two of the three containers, and TIMI 3 flow in one of the three containers.
Similar to our study, cramps were noted for all Solitaire and Merci surgeries.
There is no evidence of angiography that there is a vascular injury or thrombosis in either device.
Safety was assessed by performing three Solitaire and Merci device deployments in the opposite renal artery measuring about 2mm.
The histological evaluation of the renal artery showed that both treated vessels had acute inflammation and bleeding of the vascular outer membrane.
Both vessels have a degree of internal elastic plate degradation, the Merci equipment is more extensive, and only the Solitaire equipment has focus.
The Merci unit is formed with an original block.
This condition was not seen on angiography, but was found in histological.
Mordasini et al. Recently reported a similar animal study to evaluate the Solitaire device, which used a pig thrombosis model.
The reports of these authors are complete (TICI 3)and partial (TICI 2b)
The rate of renewal is 86. 7% and 13.
3% respectively.
Our findings suggest that the security of the Trevo device is at least comparable to that of the Solitaire and Merci devices.
In conclusion, our experimental data suggest that the Trevo device is very effective in achieving immediate re-perfusion of the occlusion artery without causing any significant clinical disruption of vascular integrity.
The author wants to thank the doctor.
Elena Ladich, MD (
Research Institute of resume path
Gaithersburg, Maryland)
Valuable work in the evaluation of pathology.
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Lake Tahoe, California, 2008 kilometers.
Raul G.
Nogueira is a member of the Scientific Advisory Committee (SAB)
For Tongxin Medical Company
Ev3 nerve and blood vessels, CoAxia Inc.
, And fast Medical
Elad I Levy received research funding, other research support (devices)
And the remuneration of Micrus Endovascular and ev3 Boston Science research support;
Ownership rights in Intratech Medical Co. , Ltd.
And Mynx/access is closed;
As SAB consultant for Cordis nerve vessels;
Serve as consultant for each project and/or hourly of Micrus Endovascular, ev3 and TheraSyn sensors;
And get the training fee for the artery stent from Abbott blood vessels and ev3.
Dr. Levy did not receive any consultation salary arrangements.
Provide all consultations per project and/or hourly. Matthew J.
Gounis is a consultant for the internal Micrus blood vessels, the Goldman nerve vessels, and Soteira Inc.
Currently, he has received research support from Philips Healthcare, Guerbet and the National Institutes of Health.
Adnan H. siddiqui, with research funding from the University of Buffalo, is a consultant to Codman/Cordis, Concentric Medical, ev3 and Micrus Endovascular, at Cordis and gen and received the honor of Neocure Genentech, the American Society of neurosurgeons course, and emergency medical conference, as well as the training provided by Cordis for other neurointervenors.
Gary Duckwiler owns shares in Tongxin Medical.
Fund Tongxin Medical Co. , Ltd.
Funding the project;
However, all performance data analysis and interpretation is carried out by the author, independent of the input or interpretation of concentric medical care.
Competitive interests yes.
Uncommissioned source and peer review;
External peer review.
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