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Introduction The iVascular neurothrombectomy devices, which include a balloon distal access catheter (iNedit), a microcatheter (iNdeep), and a stent retriever (iNtercept), have been strategically designed to incorporate the benefits of temporary proximal blood flow restriction via a balloon situated 5 cm from the catheter tip. This setup, paired with a guiding distal access catheter, facilitates clot removal through the combined action of a stent retriever and distal aspiration.Aim of Study To assess the efficacy and safety of three devices (iNedit, iNdeep, and iNtercept) in mechanical thrombectomy for patients with acute ischemic stroke due to large vessel occlusion, presented within 24 hours from symptoms onset.Method SEMTiC is a prospective, single-arm, multi-center study with blinded outcomes assessment. Efficacy endpoints: successful reperfusion (eTICI≥2b) within three passes, mRS 0–2 at 90 days and neurological improvement. Safety endpoints: all-cause mortality at 90 days and symptomatic intracranial hemorrhage (SICH).Results The whole cohort included 175 patients (mean age: 74.2±10.4 years; 49.7% female). The iVascular thrombectomy devices (iNedit, iNdeep, and iNtercept) demonstrated non-inferiority to published literature in achieving successful reperfusion (eTICI ≥2b, 75.4% in ITT, 83.6% in PP). Good functional outcomes (mRS 0–2, 55.8% ITT-56.9% PP) and neurological improvement (≥4-point NIHSS reduction, 67.3% ITT-70.9% PP) were achieved at rates comparable to other studies. Safety endpoints, including low SICH (1.7%) and mortality (13.7%), confirm the safety profile of these devicesConclusion The combination of three iVascular devices proved to be highly effective in mechanical thrombectomy, demonstrating non-inferiority in successful reperfusion parameters with no safety concerns.Conflict of Interest Yes Juan Macho collaborates with iVascular