Download Zoll Data Retriever
Fabiola Zyla
Tigertriever device and chart of patient flow through study.A, Tigertriever device including external handle for the operator to control the degree of expansion of the stent retriever. Fine wire mesh mounted on a flexible shaft. The design of the wire mesh (magnified view) is optimized to penetrate the clot and encapsulate it during retrieval. B, Patient screening, enrollment, treatment, and follow-up. ICH indicates intracranial hemorrhage; LVO, large vessel occlusion; mRS, modified Rankin Scale; and NIHSS, National Institutes of Health Stroke Scale.
Reperfusion rates were better in the current study than in the comparator studies in a variety of parameters, including first pass reperfusion, mean number of passes, reperfusion after up to 3 passes before rescue therapy, and final reperfusion after rescue therapy. First pass effect, defined as achieving mTICI 2c-3 reperfusion with one pass of the stent retriever, is likely to yield better patient outcomes and is a stringent metric to assess device performance.22 In the current study, a first pass effect was achieved in 41.4% of patients, which compares favorably to the rate of 25% in both the North American Solitaire Acute Stroke registry23 and Trevo acute ischemic stroke registry.24 In the ARISE II study, the first pass effect was seen in 40% of patients,20 which is comparable to the present study. In the current study, successful reperfusion at procedure end, including rescue therapies, was achieved in nearly every patient (96%), a value that elevates cerebral reperfusion success rates to those of cardiac reperfusion procedures.25,26
The use of a BGC in the proximal vessel of the target occlusion when prior stent retrievers are deployed has been shown to improve the first pass reperfusion effect and clinical outcomes.30 The proximal flow arrest may prevent distal embolization or non- target distal embolization. The unique design of the Tigertriever allows for more effective internalization of the thrombus into the interstices of the device. As the device is collapsed by the operator, it theoretically limits the chance of distal embolization as the clot is completely entwined in the retriever. The current study had a lower rate of BGC use at 35% in the intention to treat population, in comparison to the ARISE II trial in which this technique was used in 73.6% of patients.20 Despite the lower use of BGC in this study, there were only 4 patients (2.5%) who had an embolization to a new territory compared with 6.6% in ARISE II and to 7.4% in the pooled data from of MR CLEAN,1 ARISE II,20 REVASCAT,3 and TREVO 2.13
The clinical findings in this analysis of the ARISE II data are supported by previous literature.9 26 Zaidat et al demonstrated that patients in the North American Solitaire Stent Retriever Acute Stroke (NASA) registry (n=354) with FPE had improved functional outcomes (90-day good functional outcome: 55.1% vs 31.3%, p
Although there are factors that might affect the likelihood of achieving FPE (eg, factors related to the treating physician such as training, settings such as available equipment, and patients such as clot composition), recent research has suggested that certain techniques involving the combined use of stent retrievers and intermediate aspiration catheters could improve recanalization rates and the rate of FPE.34 35 Thus it might be beneficial to 'throw everything in' immediately to improve the likelihood of achieving FPE. In this context it might be surprising that the use of intermediate catheters was less frequent in the FPE group than in the non-FPE group (22.0% vs 50.6%, p
One of my favorite parts of my internship was having the amazing opportunity to go on the third leg of the Integrated Atlantic Sea Scallop and HabCam Research Survey and see how data that I used in my project is collected. During the first part of the voyage we collected ocean floor photos by a towed camera called HabCam. For the second part we dredged and handled a variety of ocean organisms. I was able to work with an amazing team and learned a lot!
NOAA has been collecting millions of images of the seafloor using HabCam. Having humans count benthic organisms is labor intensive. An alternative is to use computer vision. A computer vision algorithm must be trained on images that people have annotated. Then a program must be created to evaluate the algorithm while creating more training data for it. For my project, I wrote a script which successfully executed these goals and helped estimate the number of sand dollars in the Integrated Atlantic Sea Scallop and HabCam Research Survey region.
Safety and efficacy outcomes were similar when looking at the main study phase or the overall cohort encompassing the lead-in and main study phases, Gupta said. Key findings compared favorably with averaged results from three prior IDE trials stent retrievers, he reported.
GEDORE stands for top quality, innovative strength, high performance, reliability, and excellent service. Against this backdrop, GEDORE requires a flexible EDI solution that services the globally-acting business partners and their sales platforms with all individually required formats (especially EDIFACT, XML, VDA) and processes quickly and without complications. Automatic merging of EDI data with information from internal data sources (PDF) and automated dispatch of these data also play an important role. This includes integrating web shop interfaces in the central process handling of the ERP system.
The Tigertriever is a radially adjustable, fully visible stent retriever. The operator controls the device's radial expansion and force, enabling the operator to minimize vessel tension. The Tigertriever is available in Europe.
"If the goal is to have the Tigertriever be considered a viable treatment option for large-vessel occlusion stroke, then [the researchers] have accomplished that with this study, which provides the needed data for FDA approval of the device," said de Havenon.
"However, these data introduce the possibility of superiority but do not definitely show that," he concluded. "To do so, they would need a randomized trial with a comparator device or devices and, as a result, a larger sample size."
dca57bae1f