From clot to capture: LINNCing clot composition and clinical outcomes

Since its inception, CERENOVUS has been committed to studying the nature of clots, with device design based on this deep stroke science research. Join Professors Franziska DORN and Karen DOYLE speaking after a clot symposium that took place at the recent LINNC Paris 2023 course as they define clots – and the ways they retrieve them.

Prof. Doyle begins with the RESTORE Registry which since 2017 has studied thousands of clot samples – analyzed per pass – providing a profound understanding into clot composition and heterogeneity at each stage of the retrieval process. They discuss how the clots requiring more passes tend to be more white, with less red blood cells, more platelets and more collagen. It’s also discussed how the clot origin may be related to its composition with large artery atherosclerotic clots being richer in red blood cells while cardioembolic and cryptogenic clots having higher levels of the whiter components (fibrin and platelets). 

The EXCELLENT registry, which looked at the use of the EmboTrap stent retriever as a first line device is presented and results were similar to those seen in the RESTORE Registry, EXCELLENT only used Embotrap and no other stent retrievers or techniques such as direct aspiration.

If the clot is resistant to retrieval, its composition is probably more challenging (whiter, sticky) – what do we do? For Prof. Dorn, when you are facing a tough clot, you should change your technique by using a tool specially designed for these challenging clots, the Nimbus device, that includes a spiral section that acts by micro-clamping to better capture the clot. Early evidence shows that this device is safe and effective in first pass and multiple pass interventions – with results of the European SPERO study looking at the NIMBUS device when it is used to replace other devices after first or second pass failure.

What’s next in clot understanding? Can we predict clot composition before intervention, better recognize clot signature? Join this conversation and be up-to-date on where we stand today.

Sponsored by Cerenovus