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CAPTOR™ RESOLVES MAJOR UNMET CLINICAL NEED

UNMET CLINICAL NEED: HOW TO TREAT HARD CLOT IN ACUTE ISCHEMIC STROKE

  • Mechanical thrombectomy has become the first form of treatment for a clot in a major cerebral vessel inducing acute ischemic stroke. The major devices used today are either stentrievers, the metallic wires of which embed into the thrombus, or catheters to which suction is applied. 

  • None of these solutions are effective in the case of hard clot, which occurs in up to 30% of patients.

  • As a consequence, 30% of current image-guided procedures fail to remove the clot, as indicated in the studies referenced below. Thrombus may become very hard while slowly growing in the heart or cervical artery. When such thrombi embolisms into a major cerebral artery, the metallic wires of the stentriever cannot embed into it, and it is very difficult to aspirate a rock. Access to the clot using the large catheters required for aspiration may also be problematic.

  • CT and MRI before the procedure cannot differentiate soft from hard clot that would predict success with the usual devices.

  • The solution is to start with the only device that works on both soft and hard clot, surrounding the clot for first pass removal: CAPTOR™. 

REFERENCES

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  1. Goyal M, Menon BK, van Zwam WH, et al.  Endovascular thrombectomy after large-vessel ischemic stroke: a meta-analysis of individual patient data from five randomized trials. Lancet 2016; 387: 1723-31. 

  2. Kim BM. Causes and Solutions of Endovascular Treatment Failure. J Stroke 2017; 19L 131-142. 

  3. Kim BM. Refractory Occlusion to Stentriever Thrombectomy: Etiological Considerations and Suggested Solutions. In Acute Ischemic Stroke (Park J, ed; Springer, Singapore, 2017), 213-225. 

  4. Chueh J-Y, Miklos MG, Anagnostakon V, et al. Quantitative Characterization of Recanalization and Distal Emboli with a Novel Thrombectomy Device. In Cardiovasc Intervent Radiol Soc Europe (Online, Springer, Nov 2020). 

  5. Goda T, Oyama N, Kitano T et al. Factors Associated with Unsuccessful Recanalization in Mechanical Thrombectomy for Acute Ischemic Stroke. Cerebrovasc Dis Extra 2019; 9: 107-113. 

  6. Fennell VS, Swetadri VSN, Meess KM, et al. What To Do About Fibrin-rich “Tough Clots”? Comparing the Solitaire Stent Retriever with a Novel Geometric Clot Extractor in an In Vitro Stroke Model.  J Neurointervent Surg 2018; 10: 907-910. 

  7. Baek J-H, Kim BM, Heo JH, et al. Number of Stent Retriever Passes Associated with Futile Recanalization in Acute Stroke. Stroke 2018; 49: 2088-2095. 

  8. Savastino LE, Liu Y, Gebrezgiabhier D, et al. Failure Modes of Suction Catheters and Stent Retrievers in Large vessel Occlusion Stroke Discovered in a Human brain Platform. Abstracts of Accepted Abstracts for Congress of Neurological Surgeons Annual Meeting 2020; 67: 86. 

  9. Hashimoto T, Hayakama M, Funatsu N et al. Histopathologic Analysis of Retrieved Thrombi Associated with Successful Reperfusion After Acute Stroke Thrombectomy. Stroke 2016; 47: 3035-3037.  

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