A Device for Fast Mechanical Clot Retrieval From Intracranial Arteries (Phenox Clot Retriever)

Abstract

To describe a new device meant for rapid endovascular thrombectomy of intracranial arteries of various sizes and its first clinical use. A device with oriented microfilaments was constructed that consists of a core wires compound surrounded by a dense palisade of perpendicular-oriented stiff polyamid microfilaments (phenox clot retriever). The device is introduced into the target vessel through a 0.021- or 0.027-inch microcatheter, deployed distally to the thrombus, and slowly pulled back under continuous aspiration via the guiding catheter. The clinical use of the phenox clot retriever in two successive patients is described. Case 1: In a 78-year-old patient with acute posterior circulation ischemia not eligible for intravenous or intraarterial thrombolysis, endovascular recanalization of the occluded left V4 segment was possible using the phenox clot retriever within a few minutes. Case 2: A 70-year-old patient presented after the sudden onset of a left upper extremity paresis 1 day after abdominal surgery. Angiography revealed a thromboembolic occlusion of two cortical branches of the right middle cerebral artery. The rolandic artery was recanalized by a single passage of the phenox clot retriever, with complete neurological recovery. The phenox clot retriever, a flexible microfilament pattern, might be a useful supplement to the repertoire of currently available devices for endovascular intracranial thrombectomy.