Endovascular thrombectomy

Nogueira RG, Smith WS. MERCl and Multi MERCl Writing Committee. Safety and efficacy of endovascular thrombectomy in patients with abnormal hemostasis pooled analysis of the MERCl and Multi MERCl Trials. Stroke. 2009 40(2) 516-522 EPub 2008, Dec 18... 

The SMPU matrix was polyester-based thermoset (Mitsubishi Heavy Industries, Ltd). This SMPU is an amorphous material with two T s at 55°C and 115°C for the switching and hard domains, respectively. The first prototype was a flower-shaped endovascular thrombectomy device, which was intended for stroke treatment. The second prototype device was an expandable SMPU foam device for potential application in aneurysm embolization. Both devices are presented in their collapsed and deployed forms in Fig. 17. Actuation was achieved by inductively heating the... 

Figure 11.2 Schematic representation of the SMP microactuator for endovascular thrombectomy, (a) The microactuator is delivered distally through the blood clot in its secondary straight rod form (b) then the microactuator is heated to transform into its primary corkscrew form and (c) the deployed microactuator is finally retracted to capture the clot. Source Reprinted with permission Small et al. (2007a).

Small, W., et al. (2007a). Prototype fabrication and preluninary in vitro testing of a shape memory endovascular thrombectomy device. IEEE Transactions on Biomedical Engineering, 54(9), 1657-1666. 

Schumacher HC, Meyers PM, Yavagal DR, Harel NY, EUdnd MS, Mohr JP, Pile-Spellman J. Endovascular mechanical thrombectomy of an occluded superior... 

Thrombosis of AVF necessitates treatment as quickly as possible because delayed intervention allows the thrombus to propagate, and become fixed to the vein wall with a local inflammation, making any thrombectomy attempt difficult and predisposing to arterial wall damage with its risk of re-thrombosis. Thrombosed V A can be treated either by an open or endovascular intervention. Thrombectomy alone is generally insufficient unless the underlying stenotic lesion is corrected. 

Only rapid reintervention, within 12 h for surgical thrombectomy, can save the graft and does so in half of the cases. Percutaneous endovascular revascularization has been described for allograft salvage, but only for late thrombosis (Juvenois et al. 1999). 

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