Neurovascular Intervention

With experienced interventionalists, and proper patient selection following the on-label usage guidelines, the use of the Wingspan stent for intracranial atherosclerotic disease demonstrated a low periprocedural complication rate and excellent safety profile. This is the largest on-label, multicenter, prospective trial of the Wingspan stent system to date with the lowest reported complication rate.

Although their efficacy and safety have been proved for both in-stent restenosis (ISR) and native small-vessel disease, there are other emerging indications (e.g., bifurcation lesions, large-vessel disease, and high bleeding risk). Because of the recent publication of new randomized clinical trial data, the International DCB Consensus Group is updating its previous recommendations.

Sirolimus has a stronger anti-proliferation effect on atherosclerosis related hypoxic cells than paclitaxel, which may make sirolimus more suitable for the treatment of vascular restenosis. Therapeutic advantage of sirolimus seems related to inhibitions of HIF-1α expression and glycolysis.

In the past decade, tremendous progress has been made in reducing the incidence of restenosis with the advent of the drug-eluting stent (DES). With “plain old balloon angioplasty,” rates of acute and chronic vessel occlusion were unacceptably high at ≈30% to 60%, secondary to acute and chronic recoil and constrictive remodeling. The advent of bare-metal stents (BMS) appeared to eliminate the issue of acute and chronic recoil but introduced a new entity, neointimal hyperplasia (NIH), with classical papers unequivocally demonstrating a strong and linear relationship between NIH formation and late lumen loss (LLL). The restenosis rates with BMS were reported to be between 16% and 44%, with higher rates of stenosis attributable to several risk factors, in particular, long lesion length and small vessel caliber.

Our results confirm that ISR depends on multiple factors, with the ECM dynamics and SMC proliferation the primary contributors to its pathogenesis. In addition to this, the sensitivity analysis carried out for the different model parameters, as well as providing information on the stability of the model, provides us with an understanding of how changes in one parameter will affect the behaviour of the whole system.

In this retrospective, single-center experience, undersized balloon angioplasty followed by Enterprise stent deployment appears technically feasible with a relatively low rate of complications for the treatment of complex symptomatic ICAS. Prospective, multicenter, randomized controlled trials against optimal medical management are warranted.

The SAMMPRIS results do not provide evidence to support the use of PTAS using the Wingspan stent system compared with medical treatment in any examined subpopulation of patients with symptomatic intracranial stenosis, including those with qualifying event hypoperfusion symptoms.

Angioplasty and stenting for symptomatic intracranial atheromatous disease can be performed with the Gateway balloon–Wingspan stent system with a high rate of technical success and acceptable periprocedural morbidity. Our initial experience indicates that this procedure represents a viable treatment option for this patient population.

Stryker’s Wingspan Stent System (Wingspan) is used to open narrowed arteries in the brain of patients diagnosed with intracranial stenosis who are experiencing repeated strokes. Intracranial arterial stenosis, or narrowing of arteries, is a serious condition caused by a buildup of plaque within the intracranial arteries. This may be referred to as intracranial atherosclerotic disease (ICAD). Patients with intracranial stenosis are at serious risk of life-threatening strokes due to reduced blood flow to the brain from narrowed or blocked arteries, and there are few treatment options available for managing this condition.

Restenosis, a narrowing of blood vessels following angioplasty or stent placement is seen in up to 50% of patients. Cases are treated with various options, including drugs, mechanical devices such as stents, genetic treatment such as gene transfer or infusion of stem cells, and combinations of the above.

The event rate remains low over 1 year of individually tailored stenting for patients with severe symptomatic ICAS combined with poor collaterals.

Intracranial artery stenosis is the most common cause of acute ischemic stroke, especially among people in Asia. About its epidemiology, however little is understood. The goal of our research is to establish the prevalence of intracranial artery stenosis in patients with acute ischemic stroke in a tertiary care hospital.

The longer stents, balloon-mounted stents implanted in the intracranial vertebral or basilar artery, and local anesthesia were significantly associated with in-stent restenosis. Further studies are required to identify accurate biomarkers or image markers associated with ISR in ICAS patients.

Intracranial arterial stenosis (ICAS) is currently a major cause of ischemic stroke and affects almost 30% of Chinese patients who have cerebral ischemia1,2; furthermore, patients with symptomatic intracranial atherosclerotic stenosis greater than 70% have a stroke risk of 12.2% per year.

The Global Startup Heat Map below reveals the distribution of the 108 exemplary startups & scaleups we analyzed for this research. Further, it highlights 5 pharma startups that we hand-picked based on criteria such as founding year, location, funding raised, and more. You get to explore the solutions of these 5 startups & scaleups in this report. For insights on the other 103 solutions tackling strokes, get in touch.

The noninferiority of mechanical thrombectomy alone—compared to mechanical thrombectomy plus intravenous tissue plasminogen activator (IV-tPA)—for the treatment of acute ischaemic stroke has been demonstrated across more than 109,000 patients within a national US database. These results were presented at the International Symposium on Endovascular Therapy (ISET; 9–11 May, Miami, USA).

HeMo Bioengineering, a Singapore-based medical device company with a focus on treating stroke patients, has announced that its Afentta intracranial thrombectomy aspiration catheter—a product developed by the company’s branch in China—has received pre-market approval from the National Medical Products Administration (NMPA), becoming the first approved domestic product of its kind in China.

The Salt Lake City-based company, which develops not only a suite of microcatheters and guidewires but also the manufacturing technology it takes to produce them, has received $50 million in growth equity to support and expand that development.
The funding came solely from Vivo Capital, a global healthcare investment firm that has backed biotech and medtech companies through its multiple nine-figure venture funds, including, most recently, Esco Lifesciences’ $200 million series A.

According to a company press release, AlphaVac is an off-circuit, multipurpose mechanical aspiration thrombectomy device for the non-surgical removal of thrombi or emboli from the vasculature. AngioDynamics continues to anticipate the commercial release of the AlphaVac system in the second half of calendar year 2021.

Large vessel occlusion seen in 44.5 percent of those with acute ischemic stroke and SARS-CoV-2 infection

Sensome has announced its Clotild Smart Guidewire System—designed to improve the treatment of ischaemic stroke patients—has been granted a Breakthrough Device designation by the Food and Drug Administration (FDA)’s Center for Devices and Radiological Health (CDRH).

Operators considering multiple clot retrieval attempts in mechanical thrombectomy may need to take a step back, a retrospective study suggested. With each additional attempt, there was a greater incidence of emboli moving to a new territory, reflecting potential clot fragmentation, and an accompanying increase in infarct growth, reported researchers led by Wagih Ben Hassen, MD, of Sainte-Anne Hospital and the University of Paris Descartes.

Number of clot retrieval attempts linked to infarct growth, which independently predicts unfavorable outcome in acute ischemic stroke

Researchers at the University of Leeds in the UK have conducted a virtual ‘clinical trial’, using parameters from a real patient population and in silico modeling, to investigate the use of a flow diverter device in brain aneurysms. The virtual trial successfully predicted the results of real trials in humans, suggesting that the approach could be used to supplement and expedite clinical trials in the future.

The Global Startup Heat Map below reveals the distribution of the 108 exemplary startups & scaleups we analyzed for this research. Further, it highlights 5 pharma startups that we hand-picked based on criteria such as founding year, location, funding raised, and more. You get to explore the solutions of these 5 startups & scaleups in this report. For insights on the other 103 solutions tackling strokes, get in touch.