Trevo pro 18

All patients signed the informed consent at least 24 h before the procedure. All treatments were performed under general anesthesia. A 7F short sheath (Terumo, Tokyo, Japan) with a 7F guiding catheter (Guider Softip, Stryker, Kalamazoo, MI, USA) was introduced via right-sided femoral access in combination with an intermediate catheter (e. g., Navien A + 058, Medtronic, Dublin, Ireland). Heparin (3000 IU unfractionated heparin) was administered intravenously after groin puncture. All pressurized flushing solutions were heparinized (5000 IU/L). The p64 MW HPC was deployed via a Prowler Select Plus (Cerenovus, Irvine, CA, USA), a Trevo Pro 18 (Stryker Neurovascular, Fremont, CA, USA), or a Headway 21 (MicroVention Terumo, Aliso Viejo, CA, USA) microcatheter. The diameter and length of the p64 MW HPC were chosen based on two- and three-dimensional measurements of the diameter of the parent artery, the distance between the proximal and distal landing zones, the discrepancies between the diameters of the two landing zones, and the width of the aneurysm neck.

All treatments were performed in patients under general anesthesia with a 6 F guiding catheter or 8 F guiding catheter with a 5 F intermediate catheter in cases of severe vessel elongation, with guidance provided by bi-plane digital subtraction angiography (DSA) (Axiom Artis, Siemens, Erlangen, Germany; Azurion, Philips, Eindhoven). The standard approach included femoral access using short sheaths, predominantly on the right side. All FDs were deployed via Trevo Pro 18, Excelsior XT27 (Stryker Neurovascular, Kalamazoo, MI, United States), Headway 21 (MicroVention Terumo, Tokyo, Japan) or Prowler Select Plus (Cerenovus, Johnson & Johnson, New Brunswick, NJ, United States) microcatheters.
All patients undergoing FD procedures received intravenous administration of 3,000–5,000 IU heparin. Heparinized irrigation solutions were used in all catheters (5,000 IU unfractionated heparin/L). FD implantation was performed by the two most experienced interventionalists at each center.

A microcatheter (Trevo Pro18; Stryker, USA) was placed beyond the stenosis. By pulling it back, the stent struts expanded on the thrombus and the stent was set to rest for three minutes for full expansion. Afterward, aspiration was started and the stent retriever-thrombus unit slowly drawn back into the GC. If the GC happened to occlude and the vacuum pump detected flow arrest, the whole unit was drawn back through the arterial introduction sheath.