Spontaneous Trevo XP Stent-Retriever Fracture During the Mechanical Thrombectomy for Acute Ischemic Stroke Treatment: A Case Report of a Specific Device Variant and Literature Review

Abstract

Background— The Trevo® XP stent-retriever (Stryker, Fremont, CA, USA), is a Food and Drug Administration
(FDA)-approved device used in stent-assisted mechanical thrombectomy in patients with acute ischemic strokes

secondary to large vessel occlusions. Reports of failure/fracture of these devices resulting in retention of the stent-
retriever within the patient has led to a recent recall of Trevo® XP stent-retrievers with various sizes by FDA.

However, Trevo® XP stent-retriever 3mm x 20mm variant is still considered approved. Here, a case of failure and
retention of Trevo® XP stent-retriever 3mm x 20mm variant is presented.
Methods—FDA Manufacturer and User Facility Device Experience (MAUDE) database were searched using a
combination of the terms “Trevo,” “break,” “fracture,” and “stent.”
Results— A total of 482 reports were scrutinized, which resulted in identification of 45 cases which described
fracture in Trevo XP stent-retriever; none of these reports were regarding Trevo® XP stent-retriever 3mm x 20mm.
Conclusion— Stent-retriever failure and fracture is a potentially underestimated, yet serious, complication. Our
case report demonstrates that even more recently released devices have the risk of this complication. This highlights
the need for further precaution to minimize the risk and improve patient safety.