Global Trends in Thrombectomy Device and Systems Development: Retrospective Review Between 2000 and 2022

Purpose: Novel technologies have shaped modern techniques in endovascular thrombectomy to ultimately improve outcomes for high-risk or critically ill patients. The purpose of our study was to examine global trends in thrombectomy device and systems development over the past 2 decades dating from 2000 to 2022.
Materials and Methods: Global databases were accessed to compile a list of thrombectomy devices and systems submitted for regulatory approval by respective institutions and companies. Database query was between November 1, 2000, to September 1, 2022. Regulatory dossiers were examined, from which additional information, including country of origin, product territory, indications for use, device mechanism of action, and stage of development, were derived.
Results: Between the years 2000 and 2022, there were 161 thrombectomy devices and systems developed by 48 unique companies or institutions. Nineteen countries were represented with the largest global territories first in the United States followed by China and then Japan. Of these devices, 19.3% (31) are in product development, 2.5% (4) are in preclinical stages, 6.2% (10) are in the approval process, and 54.7% (88) are in clinical application. One product was entirely discontinued, and an additional 16.1% (27) are inactive or indeterminate in stage of development. By indication, neurovascular indications accounted for 58.3% (93) of all indications followed by general thrombosis at 24.8% (40) and pulmonary embolism at 9.3% (15). A total of 29.2% (47) of devices were labeled as stent-retriever thrombectomy devices, and the remaining 70.8% (114) were labeled as aspiration, manual aspiration, or thrombectomy
systems devices.
Conclusions: Global trends in thrombectomy device and systems development favor neurovascular indications with mixed device mechanisms of aspiration versus stent retriever thrombectomy systems. The United States, China, and Japan represent the largest global territories, and there are a number of devices in the developmental pipeline from each of these major product territories.