The Phenox Clot Retriever as Part of a Multimodal Mechanical Thrombectomy Approach in Acute Ischemic Stroke: Single Center Experience in 56 Patients

Purpose . We analyzed our experience with the phenox clot retriever as part of a multimodal mechanical thrombectomy (MTE) approach in acute ischemic stroke. Methods . 56 patients were treated by MTE with the phenox clot retriever alone or in combination with other modalities. Results . Overall we achieved TICI 2b/3 reperfusion rates of 61,9%. In multimodally treated patients we achieved reperfusion rates of 72,8%. There were 3 (5,5%) severe adverse events, all symptomatic intracranial hemorrhages. The mean angio to reperfusion times (ART) were 74 minutes for phenox-only procedures and 51 minutes for multimodal procedures. A chronological analysis showed a reduction of ART from 70,5 to 49,4 minutes and an increase of TICI 2b/3 recanalizations from 53,8% to 81,8%. Throughout the observation period there was a significant shift towards multimodal procedures with simultaneous increase of TICI 2b/3 reperfusions. Both effects are partially attributable to our institutional learning curve. NIHSS improvement could be seen in 54% ( n = 28) overall and in 73% ( n = 15) of MCA recanalizations. Conclusions . The phenox clot retriever is a safe and effective tool for MTE in acute stroke patients, with faster and better reperfusion results when used as part of a multimodal strategy. Clinical improvement is more frequent in MCA recanalizations.