1st Pass Success with NeVaTM M1S (4.0 x 22 mm) after failure of 2 different devices

Clinical Case Report


75 year old female patient presented with NIHSS of 19 presented 4 hours after symptom onset.

It was noted that the patient had had a knee implant surgery 3 days prior to her stroke. Additional risk factors included: Coronary Heart Failure, Hypertension, Diabetes, Atrial fibrillation​

Imaging confirmed distal left MCA occlusion.​

Professor Dr. Serdar Geyik
Istanbul Istinye University
Medical Park Hospital
Istanbul, Turkey

Pre-op Imaging

On admission CT ASPECTS was 10.

Pre-Op imaging
The Procedure

Professor Geyik and the Medical Park team decided to treat the patient with thrombectomy.

Since the occlusion was in a relatively distal branch, Dr Geyik initially tried two different brands of 3mm OD stent retriever devices. Following the failure of these two devices at achieving recanalization, he decided to give the shortest NeVa (M1S – 4 mm x 22 mm) a try. Full recanalization (TICI 3) was possible in a single NeVa pass.

Angio Showing Left MCA (distal M2 branch) Occlusion (AP Images)
Angio Showing Left MCA (distal M2 branch) Occlusion (Lateral Images)
Deployment of NeVa (4.0mm x 22mm) in the Occluded Branch

Access to the occluded site was possible despite extreme tortuosity.

Note that the DAC was parked relatively proximally to the occlusion site due to the extreme tortuosity of the branch.

Retrieval was done with aspiration via the DAC. NeVa was partially retrieved into the DAC before full removal of the full system into the long sheath.
Angio Showing Full Recanalization (TICI 3) of the Occluded Branch After the NeVa Pass
Post-Op CT
CT done at 24 hours showed minimal sub-arachnoid hemorrhage.
Procedural Statistics 2
Procedural Statistics

24 hour NIHSS of the patient was 5.

At VESALIO, we feel blessed to be part of the stroke field where together with these dedicated physicians, we can make an incredible impact on people’s lives.

Thank you Istanbul!

Clinical Success