Percutaneous Closure Device for the Carotid artery: An integrated review and design analysis

Document Type

Journal Article

Publication Date

9-22-2023

Journal

Journal of neurointerventional surgery

DOI

10.1136/jnis-2023-020702

Keywords

Artery; Carotid artery; Device; Mechanical thrombectomy; Thrombectomy; Vascular closure device

Abstract

Endovascular thrombectomies (EVTs) are the current standard of care therapy for treating acute ischemic strokes. While access through the femoral or radial arteries is routine, up to 20% of EVTs through these sites are unable to access the cerebral vasculature on the first pass. These shortcomings are commonly due to tortuous vasculature, atherosclerotic arteries, and type III aortic arch, seen especially in the elderly population. Recent studies have shown the benefits of accessing the cerebral vasculature through a percutaneous direct carotid puncture (DCP), which can reduce the time of the procedure by half. However, current vascular closure devices (VCDs) designed for the femoral artery are not suited to close the carotid artery due to the anatomical differences. This unmet clinical need further limits a DCP approach. Thus, to foster safe adoption of this potential approach, a VCD designed specifically for the carotid artery is needed. In this review, we outline the major biomechanical properties and shortcomings of current VCDs and propose the requirements necessary to effectively design and develop a carotid closure device.

Department

School of Medicine and Health Sciences Student Works

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