Letter by See et al Regarding Article, “Optimizating Clot Retrieval in Acute Stroke: The Push and Fluff Technique for Closed-Cell Stentrievers”

Haussen et al1 present an interesting series demonstrating an improvement in TICI (Thrombolysis in Cerebral Infarction) 3 revascularization using the push and fluff technique (PFT) for deploying the Trevo Retriever device (Stryker, MI) over standard unsheathing technique. PFT is an interesting technique which seems to be an adaptation of techniques first described in the pipeline embolization device, but there are distinct differences in the response of a braided stent and a closed cell laser-cut stent. The authors propose to increase radial force and clot capture of the stent by increasing coaxial force (pushing and fluffing). Although the authors suggest concerns regarding excessive radial force resulting in arterial rupture, we propose that …