4.2 Article

First Experience with the Nimbus Stentretriever A Novel Device to Handle Fibrin-rich Clots

Journal

CLINICAL NEURORADIOLOGY
Volume 33, Issue 2, Pages 491-497

Publisher

SPRINGER HEIDELBERG
DOI: 10.1007/s00062-022-01237-z

Keywords

Mechanical thrombectomy; Stroke; Reperfusion; Endovascular treatment; Second line device

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In this study, we retrospectively analyzed the data of patients treated with the Nimbus stentretriever at our high-volume stroke center. The results showed that Nimbus had a favorable effect in handling fibrin-rich clots in endovascular stroke treatment.
Purpose To share our first experience with the Nimbus stentretriever, a multizone device designed to assist neurointerventionalists in handling fibrin-rich clots in endovascular stroke treatment.Methods We retrospectively analyzed the data of patients who were treated with the Nimbus stentretriever at our high-volume stroke center between May 2021 and May 2022. We evaluated the number of passes before Nimbus was used, the number of passes with nimbus, as well as the recanalization success before and after Nimbus according to the modified treatment in cerebral ischemia (mTICI) scale. Also, patient characteristics, procedural times and clinical outcomes were documented.Results A total of 21 consecutive patients were included in the study. An mTICI 2b/3 could be achieved in 76.2% and mTICI 2c/3 could be achieved in 57.1%. The mean number of passes was 3.4 before the use of Nimbus, 2.2 with Nimbus, and 5.4 for all passes with and without Nimbus and 4 occlusions (19.0%) were successfully recanalized with direct aspiration after the use of Nimbus. We observed seven subarachnoid hemorrhages (33.3%) and two cases of vasospasm.Conclusion In our series, the use of Nimbus resulted in successful recanalization in half of the patients after otherwise unsuccessful thrombectomy maneuvers; therefore, it should be considered as a rescue option if the maneuver with conventional stent retrievers was unsuccessful.

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