The NeVa Net stent-retriever - initial report of 20 cases from two high volume centres.

Abstract

Various different technologies have been developed to optimise the mechanical thrombectomy procedure and first pass recanalisation. We report our initial experience with the NeVa NET - a novel stent-retriever with built in distal microfiltration net. We performed a retrospective review of our prospectively maintained databases to identify all patients treated with the NeVa NET 4 × 30 mm device. We recorded the baseline demographics, NIHSS, ASPECT score and clot characteristics, first pass and final eTICI scores, complications and 90 day mRS. We identified 20 patients (50% male), average age 67.9 ± 16.2 yrs, and median NIHSS 18 (range 6-29). 30% of patients received tPA. Average clot length was 21.6 ± 8.9 mm and median ASPECT score 9 (range 5-10). In 18 cases the NeVa NET could be tracked into position, however, in 2 cases it could not be tracked into position within the 0,021inch microcatheter. First pass recanalization (eTICI ≥ 2c) was seen in 94% (n = 17) and the average number of NeVa NET passes was 1. A final eTICI score of ≥ 2c was achieved in 17 patients (94%). There were no emboli to new territories. No cases of vessel rupture or dissections occured due to the NeVa NET. 50% of patients achieved mRS 0-2. SAH was seen in 31.3% and SICH in 6.3% of the 16 patients for whom a 24 h CT head was available. The NeVa Net stent-retriever is uniquely designed to prevent distal embolisation and our initial experience demonstrates a very high FPE and mFPE. We believe this is the first publication on the use of this novel technology and larger studies are warranted.