Combination
Therapy
Improve outcomes with fewer passes1,2 and
reduced risk of complications.2 See how the
right combination can make a difference.
Smoother navigation
Smoother navigation to the occlusion site using a stent retriever to guide the Aspiration catheter closer to the clot3,4
+11% increase FPE
+11% increase in First Pass Effect (FPE TICI ≥2c) vs Aspiration alone5,6
Bailout reduction
Reduces the need for bailout procedures7
Lower risk of distal embolization8,9
Higher FPE
Higher FPE is linked to better clinical outcomes10,11, lower mortality2 and greater cost savings10,11
Better outcomes
Combination technique often yield better outcomes in more complex occlusions14
Medtronic’s commitment to high-quality data
Combination Technique: First Pass Effect,
eTICI ≥2c 47.5%12
Combination Technique: Final Revascularisation,
eTICI ≥2c 72.0%12
Combination Technique:
sICH: 1.5%
33% need bailout
33% of Aspiration cases need bailout7,13,14
TICI 2c-3x more likely
3x more likely to achieve TICI 2c–3 if you switch to Combination on the 2nd pass15
Fewer passes
Fewer passes lead to better mRS outcomes1,2 and lower adverse event risks
Every extra pass with Aspiration increases the risk of
complications2 and worsens mRS outcomes1,2
It can also cause arterial collapse, especially with larger catheters in
smaller vessels.16 Aspiration alone might not be enough
If at first you don't success,
switch and try again
Boost your success with Combination therapy on your next pass.
Products that power performance
Everything you need, from one trusted source
Combination Therapy is an effective strategy when Aspiration alone isn’t enough.
These devices work together for the best results in clot retrieval
Solitaire™ X
Revascularisation Device
The original, industry-leading parametric stent retriever17 for first-pass performance2,18
- Features real-time visualisation with evenly spaced platinum markers for precise alignment and 3D feedback19, *
- Proven effectiveness with more published data than any other device in the field20
- Outperformed Trevo™* NXT and pRESET™ in lab testing21-23
Phenom™ 21/27 Catheter
Optimised to deliver all sizes of Solitaire™ X,24 ensuring smooth integration during combination therapy
- Dual braid and mid coil zones for flexibility and control25,26
- 160 cm length for easier access in triaxial setups and distal access to the clot site25,27
- Lumen integrity to resist kinking during navigation25
React™ 68/71 Aspiration Catheter
Engineered for efficient clot Aspiration
- Built with COBRA technology (COil + BRAid) for enhanced trackability and pushability28-30
- End-to-end nitinol construction provides durability and support.24,29,30,31
- Optimised for smooth navigation to M1/M2 segments
*
Based on bench testing results. Bench testing may not be representative of actual clinical performance.
†
Includes Solitaire™ X revascularization device, primarily, with Solitaire™ Platinum revascularization device. Limitations: This data is being presented in advance of publication in a peer-reviewed journal, so its review is limited to the steering committee and registry sponsor. Data is subject to change upon final publication.
1
García-Tornel Á, Requena M, Rubiera M, et al. When to stop. published correction appears in Stroke. 2020 Jun;51(6):e118]. Stroke. 2019;50(7):1781-1788.
2
Zaidat et al. First Pass Effect - A new measure for Stroke thrombectomy devices - Stroke. 2018;49:660-666
3
Li J, Tomasello A, Requena M, Ribo M. Trackability of distal access catheters: an in vitro quantitative evaluation of navigation strategies. J Neurointerv Surg. 2023 May;15(5):496-501.
4
Machi P. Direct thromboaspiration efficacy for mechanical thrombectomy is related to the angle of interaction between the aspiration catheter and the clot. J Neurointerv Surg. 2020 Apr;12(4):396-400.
5
Bourcier R. et al. Safety and efficacy of stent retrievers plus contact aspiration in patients with acute ischaemic anterior circulation stroke and positive susceptibility vessel sign in France (VECTOR): a randomised, single-blind trial. Lancet Neurol. 2024 Jul;23(7):700-711.
6
Okuda T, Arimura K, Matsuo R, et al. Efficacy of combined use of a stent retriever and aspiration catheter in mechanical thrombectomy for acute ischemic stroke J Neurointerv Surg. 2021;neurintsurg-2021–017837.
7
Gupta R, et al. Technique and impact on first pass effect primary results of the ASSIST global registry. J NeurointervSurg. 2024
8
Diana F, Vinci SL, Ruggiero M, et al. Comparison of aspiration versus combined technique as first-line approach in terminal internal carotid artery occlusion: A multicenter experience. J Neurointerv Surg. 2022;14(7):666–671.
9
Chueh JY, Puri AS, Wakhloo AK, Gounis MJ. Risk of distal embolization with stent retriever thrombectomy and ADAPT. J Neurointerv Surg. 2016;8(2):197–202.
10
Diaz et al. Economic impact of the first pass effect in mechanical thrombectomy for acute ischaemic stroke treatment in Spain: a cost-effectiveness analysis from the national health system perspective.
11
Zaidat O. Andersson et al. Health economic impact of first-pass success among patients with acute ischemic stroke treated with mechanical thrombectomy. J NeuroIntervent Surg: first published as 10.1136/neurintsurg-2020-016930 on 21 Dec 2020
12
Data on file: 2024 09 19 NTF_INSPIRE S EMEA Primary Results Data Release.
13
Diana F et al. Comparison of aspiration versus combined technique as first-line approach in terminal internal carotid artery occlusion: a multicenter experience. J Neurointerv Surg. 2022 Jul;14(7):666-671
14
Lapergue et al. Effect of Endovascular Contact Aspiration vs Stent Retriever on Revascularization in Patients With Acute Ischemic Stroke and Large Vessel Occlusion (the ASTER Randomized Clinical Trial). JAMA. 2017;318(5): 443–452.
15
Martins PN, Nogueira RG, Tarek MA, et al. Early technique switch following failed passes during mechanical thrombectomy for ischemic stroke: Should the approach change and when? J Neurointerv Surg. Published online April 4, 2024.
16
Liu Y et al. Arterial Collapse during Thrombectomy for Stroke: Clinical Evidence and Experimental Findings in Human Brains and In Vivo Models. AJNR Am J Neuroradiol. 2022 Feb;43(2):251-257. doi: 10.3174/ajnr.A7389. Epub 2022 Jan 13. PMID: 35027348; PMCID: PMC8985669.
17
Eucomed data 2024 Q1 Global and WEU.
18
Biederko et al. Improved FPE in acute stroke thrombectomy using SolitaireX compared to SolitaireFR. Front Neurol Oct2023 Vol 14.
19
TR-NV12692A
20
Jansen O, et al. Neurothrombectomy for the Treatment of Acute Ischemic Stroke: Results from the TREVO Study. Cerebrovasc. Dis. 2013;36:218-225
21
D00402644
22
D00402626
23
D00419703
24
TR-NV16168A
25
TR-NV15871A
26
D00028819A
27
R-NV15519A
28
Li J, Tomasello A, Requena M, et al. Trackability of distal access catheters: An in vitro quantitative evaluation of navigation strategies [published online ahead of print, 2022 Apr 21]. J Neurointerv Surg. 2022;neurintsurg-2022-018889.
29
TR-NV15399A
30
TR-NV15999B
31
D00033351A
This material should not be considered the exclusive source of information, it does not replace or supersede information contained in the device manual(s). Please note that the intended use of a product may vary depending on geographical approvals.
See the device manual(s) for detailed information regarding the intended use, the implant procedure, indications, contraindications, warnings, precautions, and potential adverse events.
For a MRI compatible device(s), consult the MRI information in the device manual(s) before performing a MRI. If a device is eligible for eIFU usage, instructions for use can be found at Medtronic’s website manuals.medtronic.com.
Manuals can be viewed using a current version of any major internet browser.
For best results, use Adobe Acrobat® Reader with the browser. Medtronic products placed on European markets bear the CE mark and the UKCA mark (if applicable). For any further information, contact your local Medtronic representative and/or consult Medtronic’s websites.