Mechanical Thrombectomy in Acute Terminal Internal Carotid Artery Occlusions Using a Large Manually Expandable Stentretriever (Tiger XL Device): Multicenter Initial Experience

Volker Maus; Sabeth Hüsken; Vladimir Kalousek; Grzegorz Marek Karwacki; Hannes Nordmeyer; Ilka Kleffner; Werner Weber; Sebastian Fischer

doi:10.3390/jcm10173853

Mechanical Thrombectomy in Acute Terminal Internal Carotid Artery Occlusions Using a Large Manually Expandable Stentretriever (Tiger XL Device): Multicenter Initial Experience

J Clin Med. 2021 Aug 27;10(17):3853. doi: 10.3390/jcm10173853.

Authors

Volker Maus¹, Sabeth Hüsken¹, Vladimir Kalousek², Grzegorz Marek Karwacki³, Hannes Nordmeyer^{4

5}, Ilka Kleffner⁶, Werner Weber¹, Sebastian Fischer¹

Affiliations

¹ Knappschaftskrankenhaus Bochum-Langendreer-Universitätsklinik, Institut für Diagnostische und Interventionelle Radiologie, Neuroradiologie, Nuklearmedizin, In der Schornau 23-25, 44892 Bochum, Germany.
² Subdivision of Interventional Neuroradiology, Department of Radiology, Clinical Hospital Center Sisters of Mercy, 10000 Zagreb, Croatia.
³ Luzerner Kantonsspital, Diagnostische und Interventionelle Neuroradiologie, Radiologie und Nuklearmedizin Spitalstrasse, 6000 Luzern, Switzerland.
⁴ Institut für Interventionelle Radiologie und Neuroradiologie, Neurozentrum Solingen, Radprax St. Lukas Hospital, 42697 Solingen, Germany.
⁵ School of Medicine, Department of Health, Witten/Herdecke University, 58455 Witten, Germany.
⁶ Knappschaftskrankenhaus Bochum-Langendreer-Universitätsklinik, Klinik für Neurologie, In der Schornau 23-25, 44829 Bochum, Germany.

Abstract

Background: The recently introduced Tigertriever XL Device for treatment of cerebral vessel occlusions combines manual adjustability and maximum length in one device. In this study, we report our initial experience with the Tigertriever XL in terminal ICA occlusions.

Methods: Retrospective multicenter analysis of acute terminal ICA occlusions treated by mechanical thrombectomy using the Tigertriever XL Device.

Results: 23 patients were treated using the Tigetriever XL due to an acute occlusion of the terminal ICA. The overall successful reperfusion rate after a median of two maneuvers using the Tigertriever XL Device was 78.3% (mTICI 2b-3). In 43.5% (10/23) additional smaller devices were applied to treat remaining occlusions in downstream territories, which resulted in a final successful reperfusion rate of 95.7%. Device related complications did not occur. Two symptomatic intracerebral hemorrhages (sICH) were observed.

Conclusions: The Tigertriever XL Device might be a helpful tool in the treatment of ICA terminus occlusions with large clot burden resulting in high reperfusion rates. This is mainly related to the manual adjustability of the device combined with the maximum length.

Keywords: ICA terminus; Tigertriever XL; acute stroke; mechanical thrombectomy.