Original Research Article

Optimal pinching technique for recanalization: A retrospective analysis of mechanical thrombectomy in a 3D vessel model:

Summary:
Achieving recanalization with the fewest possible passes is critical for good outcomes in mechanical thrombectomy, yet reasons for failure are often unclear. Using a 3D silicone cerebrovascular model and swine thrombi, 109 procedures were performed and fluoroscopic videos were analyzed. In cases using the pinching technique, advancing the aspiration catheter to secure firm thrombus contact improved first pass success. Pulling the stent retriever toward the aspiration catheter after contact increased effectiveness, achieving first pass recanalization in all cases. These maneuvers likely prevent thrombus stretching, maintain contact, and enable more effective pinching during retrieval, leading to higher first pass recanalization rates.

Impression:
This study provides a clear and practical insight into why first pass recanalization succeeds or fails during the pinching technique. The Blind and Replay model is innovative and helps bridge the gap between operator perception and actual device behavior. The findings offer concrete, reproducible technical tips that are directly applicable to daily practice and contribute meaningfully to optimization of combined thrombectomy techniques. (Commented by: Shinichi Yoshimura, Hyogo Medical University, Japan)

From Yoichiro Kawamura, Medical Affairs/CMO Office, Johnson & Johnson K.K. Medical Company, 3-5-2 Nishi-kanda, Chiyoda-ku, Tokyo 101-0065, Japan

View at: https://doi.org/10.1177/15910199251405097

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