New Thrombectomy System Tackles Large Clots

A novel stentriever can safely remove blood clots from intracranial vessels following ischemic stroke, helping to restore perfusion.

The Rapid Medical (Yokneam, Israel) Tigertriever XL thrombectomy system is an adjustable, fully visible clot retriever designed to treat ischemic stroke in vessels up to nine mm in diameter and up to 53mm in length. It is composed of a fully recoverable foldable wire structure made of nitinol that is mounted on a metal stem. The diameter of the mesh and the radial force on the vessel wall are mechanically adjustable by the handle, allowing optimum adaptability without causing stress on the vessel wall. The nitinol mesh is radiopaque for perfect visibility inside the vessels.

The system includes the handle and integrated slider, which controls mesh expansion, a locking-screw that sets the wire mesh at the selected diameter, and proximal and distal marker for correct positioning of the mesh inside the vessel. Percutaneous delivery is via a standard microcatheter with an internal diameter of 0.021". At the end of the procedure, the mesh is removed, resulting in recanalization of the vessel. Another advantage is that it is not necessary to continue long-term antiplatelet therapy, as required in the case of stent implantation.

“Tigertriever XL is another example of our powerful technology that adjusts to the vessel diameter for full clot removal in the treatment large vessel occlusion,” said Ronen Eckhouse, CEO of Rapid Medical. “Tigertriever XL compliments Tigertriever 13, the smallest stentriever available today, and the only stentriever indicated for distal vessel occlusion. The Tigertriever portfolio now allows surgeons to treat ischemic stroke in the majority of vessels where it occurs.”

“Tigertriever XL is a very important addition to the ischemic stroke market. For the first time, we have a tool that can be adjusted to these dimensions and is dedicated to retrieve large clot loads,” said senior interventional neuroradiologist Sebastian Fischer, MD, of Bochum University Hospital (Germany), who was the first to use the device in Europe. “This is an important addition to our current tool set, since it can potentially reduce the number of passes required to remove large stroke-causing clots, for example, in the internal carotid artery.”

Timely restoration of cerebral blood flow using reperfusion therapy is the most effective maneuver for salvaging ischemic brain tissue that is not already infarcted. For eligible patients with acute ischemic stroke, intravenous alteplase is first-line therapy, provided that treatment is initiated within 4.5 hours of clearly defined symptom onset. Mechanical thrombectomy is indicated for patients with acute ischemic stroke due to a large artery occlusion in the anterior circulation who can be treated within 24 hours of the time last known to be well, regardless of whether they receive intravenous alteplase for the same ischemic stroke event.

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