New Orleans surgeon is first in US to use new FDA-cleared device for stroke thrombectomy
Young M. Lee, MD, a cerebrovascular surgeon with University Medical Center New Orleans, was the first U.S. physician to perform a stroke thrombectomy with Thunderbolt, a computer-assisted vacuum thrombectomy (CAVT) system from Penumbra that gained U.S. Food and Drug Administration (FDA) clearance back in June.
Lee performed the procedure on a young male patient who presented with a right middle cerebral artery (MCA) syndrome and a right M1 occlusion. He spoke to Cardiovascular Business about the experience, noting that this first patient was an especially challenging case due to preexisting intracranial atherosclerotic disease.
“I was able to observe the Thunderbolt essentially detect the clot and completely aspirate the clot starting from its proximal end in the mid-M1 segment all the way up to the point of the MCA bifurcation,” he explained. “With the fluoroscopy running, I could see the aspiration catheter advance towards the MCA bifurcation as the pump responded to what was happening, which is not something you see with a traditional non-modulated aspiration technique.”
Lee noted that University Medical Center New Orleans is a comprehensive stroke center that takes pride in using the latest and greatest stroke technologies to provide high-quality care. When the Thunderbolt system gained FDA clearance, he and his colleagues knew they wanted to use it to treat patients as soon as possible.
“We were able to move fast because we have a good collaboration already in place with our neurointerventionalists and the Penumbra team,” he said. “We're always in communication about new advancements in ischemic stroke care and neuroendovascular procedures in general. The representatives are always around, supporting the technologists and the nurses with education and logistics around cases. A lot goes on behind the scenes that allows me as the neurosurgeon to focus primarily on the patient and the anatomy being treated. When you have such an infrastructure in place, it's easy to move fast and adopt new technology.”
Thunderbolt image courtesy of Penumbra.
Key details about the Thunderbolt system
According to Penumbra, Thunderbolt is the first CAVT device to receive FDA clearance for the treatment of stroke. It is powered by Penumbra’s Engine technology and uses modulated aspiration to “detect, fatigue and completely ingest” blood clots at the site of occlusion. It is also sent to customers prepackaged with one of the company’s catheters.
“This technology is different from more traditional clot removal techniques because it really aims to achieve complete clot ingestion,” Lee said. “What it is trying to do is to detect the clot and to aggressively modulate the aspiration to weaken and break up the clot so that it can be completely ingested into the catheter and into the suction canister.”
He added removing clots with Thunderbolt means clinicians no longer need to take the aspiration catheter out of the patient and then reintroduce it. This reduces the risk of vascular injury, he explained, and helps ensure a safe patient outcome.
Michael has more than 19 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.