Mechanical thrombectomy using the Nimbus stent-retriever : initial experiences in a single-center observational study

ORCID
0000-0001-5227-8803
Affiliation
Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr-University Bochum, Bochum, Germany
Boriesosdick, Jan;
Affiliation
Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr-University Bochum, Bochum, Germany
Michael, Arwed Elias;
Affiliation
Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr-University Bochum, Bochum, Germany
Kröger, Jan-Robert;
Affiliation
Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr-University Bochum, Bochum, Germany
Niehoff, Julius Henning;
Affiliation
Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr-University Bochum, Bochum, Germany
Saeed, Saher;
Affiliation
Department of Neurology and Neurogeriatrics, Johannes Wesling University Hospital, Ruhr-University Bochum, Bochum, Germany
Pflug, Marc;
Affiliation
Department of Neurology and Neurogeriatrics, Johannes Wesling University Hospital, Ruhr-University Bochum, Bochum, Germany
Schellinger, Peter;
Affiliation
Department of Radiology, Neuroradiology and Nuclear Medicine, Knappschaftskrankenhaus Langendreer, Ruhr-University Bochum, Bochum, Germany
Maus, Volker;
Affiliation
Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr-University Bochum, Bochum, Germany
Borggrefe, Jan;
GND
132366347
ORCID
0000-0003-3946-9386
LSF
52107
Affiliation
Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr-University Bochum. - Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
Mönninghoff, Christoph

Background: The Nimbus stent-retriever (NSR) was developed for mechanical thrombectomy of wall-adherent thrombi in cerebral arteries. It features a novel geometry with a proximal spiral section and a distal barrel section. The new device is designed to retrieve tough clots with a micro-clamping technique. In the first case series reporting on the NSR, we share our initial experience about the first 12 treated cases.

Methods: In total, 12 patients (5 men, 7 women; mean age 78 years) with occlusion of the internal carotid artery or the middle cerebral artery (M1 or M2 segment) were treated with the NSR, 11 after unsuccessful recanalization attempts with conventional stent-retrievers or aspiration thrombectomy.

Results: Retrieving maneuvers with the NSR recovered a thrombus in 7 patients (58%), of which 6 resulted in vessel recanalization mTICI ≥ 2b. Successful recanalization improved the mTICI score by a median of 3 points. In 5 of 7 cases, this required only one thrombectomy maneuver. In 5 cases, no improvement of recanalization could be achieved with the NSR (1–3 attempts). No NSR-related complications occurred in this case series.

Conclusions: In our initial experience, the NSR appeared to be a safe and effective second-line stent-retriever after unsuccessful MT with conventional stent-retrievers or aspiration thrombectomy allowing for mTICI ≥ 2b rescue thrombectomy in ab 50% of cases. No NSR associated complications occurred in our case series.

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