Local Experience with a New Retrievable Device for Stroke Thrombectomy in a Tertiary Academic Center

Background: Intravenous tPA has limitations in treating patients with large vessel occlusion stroke. The use of intra-arterial catheter for mechanical removal of thrombus was approved by FDA in 2004 for using MERCI Retriever. Then retrievable stents were introduced with two randomized trials showing their superiority over the MERCI device. Stents development continued with introduction of other devices including the ERIC device which is believed to have some advantages over the first generation retrievable stents. However, local published experience with the device is lacking. Methods: During a 2-year period at academic center in Jeddah, we conducted a retrospective study of all patients who were treated within 6 hours after the onset of symptoms of acute ischemic stroke and were treated with the ERIC device. All patients had confirmed proximal anterior circulation occlusion and a favorable ASPECT score on neuroimaging. Results: Nine stroke patients were enrolled in this retrospective study. The median age was 60.5 years and the median NIHSS score on admission was 19. Six patients had middle cerebral artery occlusions while one patient had terminal carotid occlusion, one basilar occlusion, and one anterior cerebral artery occlusion. Distal access catheterization was done in all but one patient. Balloon guide catheters were not used. The rate of successful angiographic reperfusion (TICI 2b or 3) with the ERIC device was 67% (six patients) while 22% (two patients) had TICI 2a score due to distal non-target embolization noted on the final angiograms. The 24 h and 7 days median NIHSS were 14 and 9, respectively. The median modified Rankin Scale on discharge was 3 and two (22%) died. One patient had symptomatic hemorrhagic transformation of the infarct. Conclusions: The ERIC device was successfully deployed in all cases and achieved reperfusion in the majority of cases with large vessel acute ischemic stroke.

Publication History

Article published online:
26 April 2021