Paper:
Immediate and 90-Day Clinical Outcome of Patients with Acute Stroke Treated with the NeVa-Vesalio Mechanical Thrombectomy Device: A Retrospective Case Series
Authors:
George-Joseph Melki, Jelle Demeestere, Annouschka Laenen, Lawrence Bonne, Eveline Claus, Julie Lambert, Pieter-Jan Buyck, Jo Peluso, Philippe Demaerel, Robin Lemmens, Geert Maleux
Journal:
World Neurosugery
Background:
Successful mechanical thrombectomy (MT) using stent retriever devices, defined as modified Treatment In Cerebral Infarction (mTICI) scores of 2b-3, is associated with improved clinical outcomes compared with medical treatment in patients with acute ischemic stroke caused by large vessel occlusion.
The NeVa stent retriever (Vesalio, Lake Forest, California, USA) is a recently developed MT device achieving promising reperfusion and first pass effect (FPE) rates in animal and in vitro studies attributing to the following properties:
1) A strong radial force and drop zones that allow resistant organized clots to integrate into the stent
2) A distally closed tip that prevents distal embolization/reocclusions
3) Good vessel wall opposition and stretch resistance during retrieval.
In this retrospective single-center study, we investigate the procedural safety and efficacy of the NeVa device and determine early and midterm clinical outcome of treated patients.
Objective:
The NeVa stent retriever is a newly designed mechanical thrombectomy device for the treatment of acute ischemic stroke caused by large vessel occlusion. We investigate the procedural characteristics and patients’ clinical outcomes at discharge and at 90 days of follow-up.
Methods:
We retrospectively reviewed a cohort of 75 patients (median age, 74 years) treated with the NeVa device for acute large vessel occlusion stroke. Per pass modified Treatment in Cerebral Infarction (mTICI) scores, procedural complications, and clinical outcome parameters including the National Institutes of Health Stroke Scale (NIHSS) score, modified Rankin Scale (mRS) score, and mortality were analyzed, based on patients’ electronic medical records.
Results:
- Complete first-pass effect was observed in 24 patients (32%).
- Vasospasm, repeated re-thrombosis, failure to advance the NeVa device through the microcatheter, and symptomatic intracranial hemorrhage were observed in 2, 1, 1, and 2 patient(s) respectively.
- The rate of complete (mTICI 2c-3) reperfusion was achieved in 61 patients (81.33%), with a median number of 2 passes (1-3). Median NIHSS score on admission, after 24 hours, and after 5-10 days or at discharge was 19 (15-23), 11 (4-19), and 3 (2-13.5), respectively.
- The number of patients with a functional mRS score (0-2) at 90 days follow-up was 29 (39%).
Conclusion:
Endovascular stroke management with use of the NeVa-Vesalio stent retriever may be associated with a 90-day functional mRS score in nearly 40% oftreated patients.
This monocenter retrospective analysis shows favorable technical early and late clinical outcome data of the use of the NeVa device, in combination with a BGC, for the treatment of stroke related to large vessel occlusion.
