Early detachment of the Solitaire stent during thrombectomy retrieval: an in vitro investigation.
J Neurointerv Surg
; 7(2): 114-7, 2015 Feb.
Article
em En
| MEDLINE
| ID: mdl-24435960
ABSTRACT
OBJECTIVE:
To elucidate the early detachment of the Solitaire stent during mechanical thrombectomy, we tested the stent in vitro under various conditions and evaluated with microscopy.METHODS:
A total of five stents were tested. Using a dynamic mechanical analysis machine, we calculated the tensile force needed for separation of the four stents from the pusher wire. Stent Nos 1 and 2 were tested without any prior manipulation. During the retraction test, no sheathing around the stent-wire junction was applied to stent No 1 whereas stent No 2 was partially covered with a sheath in accordance with instructions for use (IFU) recommendations. Stent No 3 was tested after deployment and retrieval were performed three times in an in vitro vascular replica with sheathing during retrieval. Stent No 4 was tested after one deployment and retrieval using the same replica as in stent No 3 without sheathing. In addition, forward pushing force was applied intentionally during retraction to induce excessive bending of the stent. Stent No 5 was pulled apart by both hands. After separation, stent tips and pusher wires were studied for all stents under the microscope.RESULTS:
The tensile force needed for separation was about 6â N for stent Nos 1, 2, and 3, and about 4â N for stent No 4. All of the stents showed separation at the proximal marker, not at the detachment zone.CONCLUSIONS:
Detachment of the Solitaire stent during thrombectomy can be due to separation around or inside the proximal marker. Adherence to the manufacturer's IFU of partial re-sheathing during retraction and not using the device for more than two passes might decrease the possibility of such device failure.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Teste de Materiais
/
Stents
/
Revascularização Cerebral
/
Trombectomia
/
Falha de Equipamento
Limite:
Humans
Idioma:
En
Revista:
J Neurointerv Surg
Ano de publicação:
2015
Tipo de documento:
Article