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Published Online
on February 28, 2008

Stroke. 2008
Published online before print February 28, 2008, doi: 10.1161/STROKEAHA.107.495614
A more recent version of this article appeared on April 1, 2008
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Submitted on June 12, 2007
Revised on September 6, 2007
Accepted on September 19, 2007

Mechanical Thromboembolectomy for Acute Ischemic Stroke. Comparison of the Catch Thromboectomy Device and the Merci Retriever In Vivo

Caspar Brekenfeld MD*; Gerhard Schroth MD; Marwan El-Koussy MD; Krassen Nedeltchev MD; Michael Reinert MD; Johannes Slotboom PhD; and Jan Gralla MD

From Department of Interventional and Diagnostic Neuroradiology (C.B., G.S., M.E.-K., J.S., J.G.), Department of Neurology (K.N.), Department of Neurosurgery (M.R.), University of Bern, Switzerland.

* To whom correspondence should be addressed. E-mail: Caspar.brekenfeld{at}insel.ch.

Background and Purpose—The purpose of the study was to compare efficacy and potential complications of 2 commercially available devices for mechanical thromboembolectomy.

Methods—Devices were tested in an established animal model allowing the use of routine angiography catheters and thrombectomy devices. Radio-opaque thrombi were used for visualization of thrombus–device interaction during angiography. The Merci Retrieval System and the Catch Thromboembolectomy System were assessed each in 10 vessel occlusions. For every occluded vessel up to 5 retrieval attempts were performed.

Results—Sufficient recanalization was achieved with the Merci Retriever in 90% of occlusions, and with the Catch device recanalization was achieved in 70% of occlusions. Recanalization at the first attempt occurred significantly more often with the Merci Retriever compared to the Catch device (OR, 21; 95% CI, 1.78–248.11). Consequently, significantly more attempts (P=0.02) had to be performed with the Catch device; therefore, time to recanalization was longer. Thrombus fragmentations during retrieval were caused more often by the Catch device compared to the Merci Retriever (OR, 15.6; 95% CI, 1.73–140.84), resulting in a higher distal embolization rate. During retrieval both devices lost thrombotic material at the tip of the guide catheter, which was then aspirated in most cases.

Conclusions—Both distal devices are effective for thromboembolectomy. To avoid loss of thrombotic material and distal embolization, the use of large luminal balloon guide catheters and aspiration during retrieval seems to be mandatory. The design of the Merci Retriever appears to be more efficient during thrombus mobilization and retrieval with less fragmentation compared to the Catch Thromboembolectomy System.


Key words: interventional treatment • mechanical embolectomy • stroke