Use of the New Solitaire™ AB Device for Mechanical Thrombectomy When Merci Clot Retriever Has Failed to Remove the Clot

Abstract

The Merci Retrieval System™ (Concentric Medical, Mountain View, CA, USA) was approved in 2004 for restoring blood flow in patients experiencing an acute stroke who are otherwise ineligible for intravenous tPA, or in whom intravenous tPA treatment has failed. However, this treatment results in successful recanalization in less than 60% of treatable vessels (Multi MERCI trial). We describe the use of a novel device, the Solitaire™ AB Neurovascular Remodeling Device (ev3 Inc., Irvine, CA, USA) that received the CE Mark for the treatment of neurovascular disease in 2007 and can recanalize arteries when MERCI has failed. We describe a case of mechanical thrombectomy in which a new device, Solitaire™ AB, was used for acute cerebral ischemia in the setting of middle cerebral artery occlusion after unsuccessful recanalization with the MERCI® Retriever. Excellent angiographic and good clinical results were obtained without any complication. The Solitaire™ AB device was able to retrieve and remove clots efficiently from the middle cerebral artery when the MERCI system failed, thereby offering a new alternative in the treatment of acute ischemic stroke.