Clinical Scorecard: Initial Findings from 20 Cases Utilizing the NeVa Net Stent-Retriever in Two High-Volume Centers

At a Glance

Key Highlights

• NeVa NET incorporates a dual-layered nitinol braid 'NET' designed to capture microemboli <400 microns, aiming to reduce distal embolisation during thrombectomy.
• Initial retrospective analysis of 20 patients showed use of NeVa NET as first-line device with median NIHSS 18 and 30% receiving IV tPA prior to thrombectomy.
• Device available in two sizes (5.5 × 37 mm and 4 × 30 mm) compatible with standard microcatheters, with radial force comparable to Solitaire 6 × 30 mm device.

Guideline-Based Recommendations

Diagnosis

• Confirm LVO via CT angiography from arch to vertex prior to thrombectomy.
• Assess ASPECT score ≥ 3 to determine eligibility for mechanical thrombectomy.
• Evaluate NIHSS score > 5 and life expectancy > 6 months for patient selection.

Management

• Perform mechanical thrombectomy using NeVa NET as first-line stent-retriever device.
• Administer IV tPA if patient meets criteria prior to thrombectomy.
• Use local or general anesthesia based on operator discretion.
• Employ ancillary devices such as balloon guide catheters and distal aspiration catheters as per operator preference.

Monitoring & Follow-up

• Perform post-procedural imaging at 24 ± 6 hours or earlier if neurological deterioration occurs.
• Record eTICI score after first pass and at procedure end to assess recanalization success.
• Assess 90-day modified Rankin Scale (mRS) via telephone or clinic follow-up.

Risks

• Potential for distal embolisation minimized by NeVa NET design but procedural complications should be monitored.
• Incomplete data sets or use of alternative initial devices excluded from analysis.

Patient & Prescribing Data

20 patients with acute ischemic stroke due to LVO treated with NeVa NET as first-line device

Median NIHSS 18, 30% received IV tPA prior to thrombectomy, majority had mRS 0 or 1 pre-stroke, left-sided occlusions more common (60%), cardioembolic cause predominant

Clinical Best Practices

• Select patients with NIHSS > 5, ASPECT score ≥ 3, and life expectancy > 6 months for NeVa NET thrombectomy.
• Use CT angiography for precise occlusion localization and procedural planning.
• Consider use of balloon guide catheters and distal aspiration catheters to optimize thrombectomy outcomes.
• Monitor recanalization success with eTICI scoring and follow neurological status closely post-procedure.
• Record functional outcomes at 90 days to evaluate long-term efficacy.

References

• Millipede Aspiration Catheter
• Walrus Balloon Guide Catheter
• Embotrap Stent-Retriever
• ERIC Stent-Retriever
• NeVa NET Device
• Solitaire Device