A device for fast mechanical clot retrieval from intracranial arteries (phenox clot retriever)

Introduction: To describe a new device meant for rapid endovascular thrombectomy of intracranial arteries of various sizes and its first clinical use. Methods: 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. Results: 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. Conclusion: The phenox clot retriever, a flexible microfilament pattern, might be a useful supplement to the repertoire of currently available devices for endovascular intracranial thrombectomy.