Saturday, December 26, 2020

Mechanical thrombectomy with a novel device: initial clinical experience with the ANATM thrombectomy device

Once again the wrong endpoint is measured; reperfusion, NOT 100% RECOVERY.  Until we get that as the endpoint will we ever get close to solving stroke.

Mechanical thrombectomy with a novel device: initial clinical experience with the ANATM thrombectomy device

DavidHernandezaCarlosPiñanaaManuelRequenabDavid S.LiebeskindcRaul G.NogueiradTudorJovineTommyAnderssonfgChristophCognardhAdnanSiddiquiiMarcRibob
Under a Creative Commons license
open access

Highlights

The ANA™ thrombectomy system is a novel stroke thrombectomy device comprising a self-expanding funnel designed to reduce clot fragmentation by locally restricting flow while becoming as wide as the lodging artery.

In in vitro phantom and swine models ANA™ device showed high recanalization rates with no safety concerns.

In this first-in-human study, the ANA™ device achieved a high rate of complete reperfusion, sudden recanalization, and a good safety profile.

Abstract

Introduction

The ANA™ (Anaconda Biomed) thrombectomy system is a novel stroke thrombectomy device comprising a self-expanding funnel designed to reduce clot fragmentation by locally restricting flow while becoming as wide as the lodging artery. Once deployed, ANA allows distal aspiration in combination with a stentretriever (SR) to mobilize the clot into the funnel where it remains copped during extraction. We investigate safety and efficacy of ANA™ in a first-in-man study.

Methods

Prospective data was collected on 35 consecutive patients treated as first line with ANA™ at a single centre. Outcome measures included per-pass reperfusion scores, symptomatic intracerebral hemorrhage (sICH), NIHSS at day 5, and mRS at 90 days.

Results

Median NIHSS was 12(9-18). Sites of primary occlusion were: 5 ICA, 15 M1-MCA, 15 M2-MCA. Primary performance endpoint, mTICI 2b-3 within 3 passes without rescue therapy was achieved in 91.4% (n = 32) of patients; rate of complete recanalization (mTICI 2c-3) was 65.7%. First pass complete recanalization rate was 42.9%, and median number of ANA passes 1(IQR: 1-2). In 17.1% (n = 6) rescue treatment was used; median number of rescue passes was 2(1-7), leading to a final mTICI2b-3rate of 94.3% (n = 33). There were no device related serious adverse events, and rate of sICH was 5.7% (n = 2). At 5 days median NIHSS was 1 (IQR 1-6) and 90 days mRS 0-2 was achieved in 60% of patients.

Conclusions

In this initial clinical experience, the ANA™ device achieved a high rate of complete recanalization with a good safety profile and favourable 90 days clinical outcomes.

 
 

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