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Mechanical Thrombectomy in Acute Ischemic Stroke Using a Manually Expandable Stent Retriever (Tigertriever)

Preliminary Single Center Experience

Clinical Neuroradiology volume 31, pages 491–497 (2021)Cite this article

Abstract

Objective

The aim of this study was to evaluate the safety and efficacy of a manually expandable stent retriever (Tigertriever, Rapid Medical, Yoqneam, Israel) in the treatment of acute ischemic stroke caused by intracranial large vessel occlusions (LVO).

Methods

We performed a single center retrospective analysis of all patients treated by mechanical thrombectomy due to LVO using the Tigertriever. The angiographic and clinical success was evaluated by the modified thrombolysis in cerebral infarction score (mTICI) and the modified Rankin score (mRS).

Results

A total of 68 acute intracranial arterial occlusions in 61 patients (42 female, median age 77 years, range 43–92 years) were treated by mechanical thrombectomy using the Tigertriever. The overall successful reperfusion rate (mTICI 2b-3) was 85.3% (58/68 occlusions) with a first pass effect (mTICI 3) of 23.5% (16/68 occlusions). In 57 of the 68 occlusions the Tigertriever was used on an intention to treat approach with a success rate of 86.0% and in the 11 remaining occlusions where the Tigertriever was used as a bail-out device the success rate was 81.9%. In seven patients a mild subarachnoid hemorrhage occurred (11.5%) and one symptomatic intracerebral hemorrhage was observed (1.6%). At discharge 39.3% of the patients (24/61) had a favorable outcome (mRS 0–2).

Conclusion

The Tigertriever offers a safe and effective treatment option in ischemic stroke due to LVOs with reperfusion rates and a safety profile similar to alternative devices. The Tigertriever is a promising bail-out tool in complex cases. Its role as a first line device has to be evaluated in further prospective studies.

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Fig. 1
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Abbreviations

CT:

Computed tomography

ENT:

Embolism in new territory

F:

French

ICA:

Internal carotid artery

IVT:

Intravenous thrombolysis

LVO:

Large vessel occlusion

mTICI:

Modified thrombolysis in cerebral infarction

NIHSS:

National Institutes of Health Stroke Scale

PTA:

Percutaneous transluminal angioplasty

SAH:

Subarachnoid hemorrhage

sICH:

Symptomatic intracerebral hemorrhage

VA:

Vertebral artery

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Funding

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors

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Authors and Affiliations

  1. Institut für Diagnostische und Interventionelle Radiologie, Neuroradiologie und Nuklearmedizin, Knappschaftskrankenhaus Bochum-Universitätsklinikum Bochum, In der Schornau 23–25, 44829, Bochum, Germany

    L. Will, V. Maus, A. Weber, W. Weber & S. Fischer

  2. Klinik für Diagnostische, Radiologie und Neuroradiologie, Universitätsklinikum Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany

    C. Maurer

Authors
  1. L. Will
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  2. V. Maus
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  3. C. Maurer
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  4. A. Weber
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  5. W. Weber
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  6. S. Fischer
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Contributions

Lena Will: data acquisition, analysis and interpretation, writing of the manuscript. Volker Maus: critical review of the work. Cristoph Maurer: critical review of the work. Anushe Weber: critical review of the work. Werner Weber: critical review of the work. Sebastian Fischer: conception and design of the study, data acquisition, analysis and interpretation, writing of the manuscript, final approval of the manuscript

Corresponding author

Correspondence to S. Fischer.

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Conflict of interest

S. Fischer: support for travel to meetings. L. Will, V. Maus, C. Maurer, A. Weber and W. Weber declare that they have no competing interests.

Additional information

Data and material are available on reasonable request from the corresponding author.

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Will, L., Maus, V., Maurer, C. et al. Mechanical Thrombectomy in Acute Ischemic Stroke Using a Manually Expandable Stent Retriever (Tigertriever). Clin Neuroradiol 31, 491–497 (2021). https://doi.org/10.1007/s00062-020-00919-w

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  • DOI: https://doi.org/10.1007/s00062-020-00919-w

Keywords

  • Stent retriever
  • Tigertriever
  • Ischemic stroke
  • Large vessel occlusion
  • Mechanical thrombectomy