NEVA NET 5.5 FIRST CLINICAL MULTICENTER EXPERIENCE

Paper:
First clinical multicenter experience of the new NeVa NET 5.5 thrombectomy device
Authors:
Roland Schwab, Balázs Kis, Berki Alexandra Réka, Janos Sebestyen Gellen, Katharina Haider, Eya Khadhraoui, Sebastian Johannes Müller, Erelle Fuchs, Maximilian Thormann, Johannes Alex Rolf Pfaff, Daniel Behme
Journal:

Journal of Neuro-Interventional Surgery – JUNE 2025

Background:
Mechanical thrombectomy for the treatment of acute ischemic stroke has undergone relevant technical improvements over recent years. However, distal emboli and incomplete reperfusion after mechanical thrombectomy are still shortcomings in the care of patients with endovascular acute ischemic stroke. The NeVa NET 5.5 thrombectomy device (Vesalio, Nashville, Tennessee, USA) is the first stent retriever featuring an integrated clot micro-filtration system, aiming to enhance first pass efficacy and reduce distal embolization. This study evaluates the safety and efficacy of the NeVa NET 5.5 thrombectomy device.
Methods:

Patients with acute anterior circulation occlusions and vessel diameters >2 mm treated with the NeVa NET 5.5 stent retriever as a first-line approach were retrospectively included in this study. Data were collected from three European comprehensive stroke centers between October 2022 and April 2024. Patient data, occlusion details, clinical outcomes, and procedure-related parameters were analyzed.

Results:
  • A total of 51 patients were included
  • The most common occlusion locations were the internal carotid artery terminus and intradural internal carotid artery (70.6%)
  • The mean±SD clot length was 25.1±13.3 mm (range 4–50 mm)
  • First pass reperfusion (eTICI 2b–3) was achieved in 78.5%, with a final reperfusion rate of eTICI 2b–3 in 98.1%
  • Distal embolization in new territories occurred in 3.9%
  • No device-related adverse events were reported, and procedure-related adverse events occurred in 7.6% of the overall included cases

Recanalization Results:

Discussion:

NeVa NET 5.5 had better recanalization rates compared to NeVa in the CLEAR study and to Solitaire, Trevo, and Embotrap in the MAESTRO I meta-analysis despite the much higher rates of ICA occlusions in this study cohort:

Recanalization Comparisons:

  • The ICA occlusions subgroup analysis revealed a higher first-pass TICI 2b-3 rate of 83% versus the 32.6% reported by Riegler et al reported in a similar cohort of 2312 patients
  • Distal embolization comparisons were favorable to NeVa NET 5.5, despite clot lengths of up to 50 mm, potentially explained by the low number of passes (mean±SD 1.7±1.1) in combination with the protective mechanism of the integrated micro- filter in the distal tip of the NeVa NET
  • ICH rate of 23.5% and sICH rate of 3.9% were consistent with previously reported rates in similar populations
  • Patient outcomes were consistent with outcomes in similar, ICA-occlusion dominant populations with poor collaterals
Conclusion:

The NeVa NET 5.5 stent retriever has a high first pass reperfusion rate in large vessel occlusions of the anterior circulation, with a good safety profile and low rate of distal embolization.

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