Stent-Retriever Anchoring Technique in Tortuous Anatomy Thrombectomy

29 October 2025

by Professor Ashutosh Jadhav, MD, PhD and Dr. Wittawat Takong

Prof. Ashutosh Jadhav, MD, PhD and Dr. Wittawat Takong

Case Overview

A patient presented with a distal M1 occlusion and severe tortuosity, making direct aspiration difficult. Despite successful microwire and microcatheter navigation, the aspiration system lost support and could not cross the curvature.

The stent-retriever anchoring technique was used to stabilize the system and allow safe, controlled advancement of the aspiration catheter. First-pass recanalization was achieved.

1. Setup

Advance the microwire and microcatheter distally to the target site for stent retriever deployment.

A longer microcatheter (~160 cm) may improve reach and support in extended anatomy.

2. Establish the Anchor

Deploy the stent retriever distally to create a stable fixation point against the vessel wall.
The stent’s radial force creates a firm distal fixation point that stabilizes the system.

3. Advance the Aspiration Catheter

With the stent retriever anchored, gently advance the aspiration catheter over the retriever wire.
The anchor converts forward force into smooth, coaxial tracking, even through double-curve or S-shaped segments.
Once at the clot face, proceed with the combined technique.

Anchoring restores stability and trackability in tortuous anatomy, enabling safe first-pass recanalization when direct navigation is limited.

Courtesy: Dr. Wittawat Takong, Bangkok Hospital Pattaya, Thailand

Devices used: Supernova 4×43 mm Stent Retriever | Neutron 0.070 Aspiration Catheter