A comparative study on the efficacy of two different types of intracranial stent retrievers based on finite element simulation.

Abstract

This study investigates the thrombectomy performance of open (Solitaire FR 6 × 30) and closed (Trevo XP ProVue 6 × 25) stent retrievers in patient-specific vasculature using finite element analysis (FEA). The aim is to inform stent design optimization and improve surgical strategies. Patient-specific vascular models, thrombus models, and stent retriever models were constructed using CAD software. FEA simulated the thrombectomy procedure, and the simulation results were validated through in vitro experiments. The FEA predicted successful thrombus retrieval with the Solitaire FR 6 × 30, consistent with in vitro findings. Conversely, the Trevo XP ProVue 6 × 25 failed to retrieve the thrombus in the simulation. During Solitaire FR 6 × 30 thrombectomy, maximum thrombus stress (48.733 MPa), strain (2.257) and contact pressure on the vessel wall (7.177 MPa) were substantially higher than those observed during Trevo XP ProVue 6 × 25 thrombectomy (15.824 MPa, 1.554, and 1.872 MPa, respectively). Specifically, the Solitaire FR 6 × 30 induced 3.19 times greater maximum thrombus stress, 1.45 times greater maximum thrombus strain, and 2.83 times greater maximum vessel wall contact pressure. These findings suggest that the Solitaire FR stent retriever demonstrates superior thrombectomy efficacy compared to the Trevo XP stent retriever, likely attributable to its higher radial support force. However, the increased force exerted on the thrombus and vessel wall by the Solitaire FR raises the potential risk of thrombus fragmentation and vascular injury.