2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T7a1,Large vessel occlusion (LVO) stroke is associated with a high risk of permanent disability. There are no reliable tools providing periprocedural information on clot characteristics, such as composition and length, that may impact first pass effect, which has been shown to improve functional outcomes. In the first study of a novel technology, we evaluated whether the Clotild Smart Guidewire System (Clotild), an impedance-based device, can provide in situ information on clot characteristics during a mechanical thrombectomy procedure. This is the first-in-human, international, multicentric, single-arm trial involving LVO stroke patients. Of 45 enrolled subjects, 41 constituted the safety population; 39 was the per protocol population, of which 26 subjects with complete impedance data comprised the performance population. The latter was divided into development (11 subjects) and validation (15 subjects) populations for prediction model development and assessment. The safety endpoint assessed Clotild-related intracranial vessel perforation/dissection. Performance endpoints evaluated Clotild's ability to perform classification of impedance measurements distinguishing substantial versus negligible local content in red blood cells (RBCs) and platelets, to detect the arterial wall and the distal end of the clot. The safety endpoint was met in all subjects. Performance analysis comparing the agreement between Clotild's output and impedance experts' readings showed an area under the receiver operating characteristic curve (AUC) of 0.97 (95% CI 0.93 to 0.99) for RBC, and 0.94 (95% CI 0.89 to 0.98) for platelet clot composition. Regarding detection, Clotild's performance showed an AUC of 0.69 (95% CI 0.59 to 0.77) for the arterial wall, and 0.83 (95% CI 0.59 to 1.00) for the distal end of the clot. Clotild was proven safe to acquire impedance data and to provide information on in situ clot characteristics in large vessel occlusions.31:T9f2, Background Large vessel occlusion (LVO) stroke is associated with a high risk of permanent disability. There are no reliable tools providing periprocedural information on clot characteristics, such as composition and length, that may impact first pass effect, which has been shown to improve functional outcomes. In the first study of a novel technology, we evaluated whether the Clotild Smart Guidewire System (Clotild), an impedance-based device, can provide in situ information on clot characteristics during a mechanical thrombectomy procedure. Methods This is the first-in-human, international, multicentric, single-arm trial involving LVO stroke patients. Of 45 enrolled subjects, 41 constituted the safety population; 39 was the per protocol population, of which 26 subjects with complete impedance data comprised the performance population. The latter was divided into development (11 subjects) and validation (15 subjects) populations for prediction model development and assessment. The safety endpoint assessed Clotild-related intracranial vessel perforation/dissection. Performance endpoints evaluated Clotild’s ability to perform classification of impedance measurements distinguishing substantial versus negligible local content in red blood cells (RBCs) and platelets, to detect the arterial wall and the distal end of the clot. Results The safety endpoint was met in all subjects. Performance analysis comparing the agreement between Clotild’s output and impedance experts’ readings showed an area under the receiver operating characteristic curve (AUC) of 0.97 (95% CI 0.93 to 0.99) for RBC, and 0.94 (95% CI 0.89 to 0.98) for platelet clot composition. Regarding detection, Clotild’s performance showed an AUC of 0.69 (95% CI 0.59 to 0.77) for the arterial wall, and 0.83 (95% CI 0.59 to 1.00) for the distal end of the clot. Conclusions Clotild was proven safe to acquire impedance data and to provide information on in situ clot characteristics in large vessel occlusions. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Impedance-Based Clot Characterization: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Impedance-Based Clot Characterization (modality). Clinician-written summaries and actionable practice insights. 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Performance analysis comparing the agreement between Clotild's output and impedance experts' readings showed an area under the receiver operating characteristic curve (AUC) of 0.97 (95% CI 0.93 to 0.99) for RBC, and 0.94 (95% CI 0.89 to 0.98) for platelet clot composition. Regarding detection, Clotild's performance showed an AUC of 0.69 (95% CI 0.59 to 0.77) for the arterial wall, and 0.83 (95% CI 0.59 to 1.00) for the distal end of the clot.","abstract":"$30","keywords":["Device","Stroke","Thrombectomy","guidewire"],"pubmed_id":"42070796","conclusions":"","publication_date":"2026-05-04T00:00:00"},"crossref":{"DOI":"10.1136/jnis-2025-024772","URL":"https://doi.org/10.1136/jnis-2025-024772","ISSN":["1759-8478","1759-8486"],"link":[{"URL":"https://syndication.highwire.org/content/doi/10.1136/jnis-2025-024772","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"jnis-2025-024772","type":"journal-article","issue":null,"score":1,"title":["In situ impedance analysis device for clot characterization in large vessel occlusion acute ischemic stroke, a first-in-human study"],"author":[{"given":"Andrew","family":"Cheung","sequence":"first","affiliation":[{"name":"Liverpool Hospital, Liverpool, New South Wales, 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Hospitalier Universitaire de Limoges, Limoges, France"}]},{"given":"Vinicius","family":"Carraro do Nascimento","sequence":"additional","affiliation":[{"name":"Gold Coast University Hospital, Southport, Queensland, Australia"}]},{"given":"Géraud","family":"Forestier","sequence":"additional","affiliation":[{"name":"Interventional Neuroradiology, Centre Hospitalier Universitaire de Limoges, Limoges, France"}]},{"given":"Julie","family":"Lafaurie-Janvore","sequence":"additional","affiliation":[{"name":"Sensome SAS, Massy, France"}]},{"given":"Joachim","family":"Rambeau","sequence":"additional","affiliation":[{"name":"Sensome SAS, Massy, France"}]},{"given":"Franz","family":"Bozsak","sequence":"additional","affiliation":[{"name":"Sensome SAS, Massy, France"}]},{"given":"Ramanathan","family":"Kadirvel","sequence":"additional","affiliation":[{"name":"Mayo Clinic Minnesota, Rochester, Minnesota, USA"}]},{"given":"Karen","family":"Doyle","sequence":"additional","affiliation":[{"name":"Physiology & CÚRAM- Research Ireland Centre for Medical Devices, University of Galway, Galway, Ireland"}]},{"given":"Waleed","family":"Brinjikji","sequence":"additional","affiliation":[{"name":"Mayo Clinic Minnesota, Rochester, Minnesota, USA"}]},{"given":"David S","family":"Liebeskind","sequence":"additional","affiliation":[{"name":"Neurology, UCLA, Los Angeles, California, USA"}]},{"given":"Aymeric","family":"Rouchaud","sequence":"additional","affiliation":[{"name":"Interventional Neuroradiology, Centre Hospitalier Universitaire de Limoges, Limoges, France"}]},{"given":"Dennis","family":"Cordato","sequence":"additional","affiliation":[{"name":"Liverpool Hospital, Liverpool, New South Wales, Australia"},{"name":"Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia"}]}],"funder":[{"name":"Research Ireland and the European Regional Development Fund","award":["13/RC/2073_P2"],"award-info":[{"award-number":["13/RC/2073_P2"]}]},{"name":"Sensome","award":["N/A"],"award-info":[{"award-number":["N/A"]}]}],"issued":{"date-parts":[[2026,5,3]]},"member":"239","prefix":"10.1136","source":"Crossref","volume":null,"created":{"date-time":"2026-05-04T01:25:11Z","timestamp":1777857911000,"date-parts":[[2026,5,4]]},"indexed":{"date-time":"2026-05-05T02:52:30Z","timestamp":1777949550845,"date-parts":[[2026,5,5]]},"license":[{"URL":"https://creativecommons.org/licenses/by/4.0/","start":{"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000,"date-parts":[[2026,5,4]]},"delay-in-days":1,"content-version":"unspecified"}],"subject":[],"abstract":"$31","accepted":{"date-parts":[[2026,4,6]]},"language":"en","relation":{},"resource":{"primary":{"URL":"https://jnis.bmj.com/lookup/doi/10.1136/jnis-2025-024772"}},"subtitle":[],"deposited":{"date-time":"2026-05-04T01:25:18Z","timestamp":1777857918000,"date-parts":[[2026,5,4]]},"issn-type":[{"type":"print","value":"1759-8478"},{"type":"electronic","value":"1759-8486"}],"published":{"date-parts":[[2026,5,3]]},"publisher":"BMJ","reference":[{"DOI":"10.1016/S0140-6736(16)00163-X","key":"2026050318250573000_jnis-2025-024772v1.1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":null,"key":"2026050318250573000_jnis-2025-024772v1.2","year":"2023","issue":null,"author":"Nguyen","volume":"3","first-page":null,"unstructured":null,"article-title":"Mechanical 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red blood cell-rich content in acute ischemic stroke clots ex vivo associated with first-pass successful recanalization","journal-title":"Res Pract Thromb Haemost","doi-asserted-by":"crossref"},{"DOI":"10.1136/jnis-2025-023658","key":"2026050318250573000_jnis-2025-024772v1.19","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"Sahin C , Giraud A , Sak NG , et al . Electrical impedance spectroscopy signatures of red blood cells and platelets in acute ischemic stroke clots in the Clotbase International Registry: significance for etiology and first pass effect. J Neurointerv Surg 2025;jnis–2025. doi:10.1136/jnis-2025-023658","article-title":null,"journal-title":null,"doi-asserted-by":"crossref"},{"DOI":"10.1161/STROKEAHA.118.023419","key":"2026050318250573000_jnis-2025-024772v1.20","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1177/15910199231175377","key":"2026050318250573000_jnis-2025-024772v1.21","year":"2025","issue":null,"author":"Darcourt","volume":"31","first-page":"584","unstructured":null,"article-title":"Identifying ex vivo acute ischemic stroke thrombus composition using electrochemical impedance spectroscopy","journal-title":"Interv Neuroradiol","doi-asserted-by":"crossref"},{"DOI":"10.1136/svn-2021-001038","key":"2026050318250573000_jnis-2025-024772v1.22","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.4103/bc.bc_81_21","key":"2026050318250573000_jnis-2025-024772v1.23","year":"2022","issue":null,"author":"Johnson","volume":"8","first-page":"87","unstructured":null,"article-title":"Impact of histological clot composition on preprocedure imaging and mechanical thrombectomy","journal-title":"Brain Circ","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.bios.2011.09.007","key":"2026050318250573000_jnis-2025-024772v1.24","year":"2011","issue":null,"author":"Yu","volume":"30","first-page":"165","unstructured":null,"article-title":"Electrochemical impedance spectroscopy to characterize inflammatory atherosclerotic plaques","journal-title":"Biosens Bioelectron","doi-asserted-by":"crossref"}],"short-title":[],"update-policy":"https://doi.org/10.1136/crossmarkpolicy","alternative-id":["10.1136/jnis-2025-024772"],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"original-title":[],"container-title":["Journal of NeuroInterventional Surgery"],"reference-count":24,"published-online":{"date-time":null,"timestamp":null,"date-parts":[[2026,5,3]]},"references-count":24,"short-container-title":["J NeuroIntervent Surg"],"is-referenced-by-count":0},"unpaywall":{"doi":"10.1136/jnis-2025-024772","is_oa":true,"title":"In situ impedance analysis device for clot characterization in large vessel occlusion acute ischemic stroke, a first-in-human study","updated":"2026-05-05T11:59:32+00:00","published_date":"2026-05-03","best_oa_location":{"url":"https://doi.org/10.1136/jnis-2025-024772","pmh_id":null,"url_for_pdf":null,"url_for_landing_page":"https://doi.org/10.1136/jnis-2025-024772"}}},"created_at":"2026-05-07T22:51:02.112Z","updated_at":"2026-05-14T15:13:26.918Z","tags":[{"paper_doi":"10.1136/jnis-2025-024772","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1136/jnis-2025-024772","tag_type":"brand","value":"Clotild Smart Guidewire System","value_numeric":null},{"paper_doi":"10.1136/jnis-2025-024772","tag_type":"category","value":"Surgery","value_numeric":null},{"paper_doi":"10.1136/jnis-2025-024772","tag_type":"condition","value":"Large Vessel Occlusion Acute Ischemic Stroke","value_numeric":null},{"paper_doi":"10.1136/jnis-2025-024772","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1136/jnis-2025-024772","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1136/jnis-2025-024772","tag_type":"modality","value":"Impedance-Based Clot Characterization","value_numeric":null},{"paper_doi":"10.1136/jnis-2025-024772","tag_type":"modality","value":"Mechanical Thrombectomy Device","value_numeric":null},{"paper_doi":"10.1136/jnis-2025-024772","tag_type":"sample_size","value":"n=41","value_numeric":41},{"paper_doi":"10.1136/jnis-2025-024772","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1136/jnis-2025-024772","tag_type":"study_design","value":"First-in-Human Single-Arm Trial","value_numeric":null},{"paper_doi":"10.1136/jnis-2025-024772","tag_type":"warning","value":"Level of evidence assigned as 3 (single-arm first-in-human trial); no control group or randomization was used.","value_numeric":null},{"paper_doi":"10.1136/jnis-2025-024772","tag_type":"warning","value":"Performance analysis was based on only 26 subjects with complete impedance data, divided into very small development (n=11) and validation (n=15) subsets — results should be interpreted with caution.","value_numeric":null},{"paper_doi":"10.1136/jnis-2025-024772","tag_type":"warning","value":"The comparator for performance endpoints was impedance experts' readings, not histopathology; true diagnostic accuracy against a tissue gold standard is unknown.","value_numeric":null}],"summaries":{"what_studied":"This first-in-human, international, multicenter, single-arm trial evaluated the Clotild Smart Guidewire System — an impedance-based device — for in situ clot characterization (RBC/platelet composition, arterial wall detection, distal clot end detection) during mechanical thrombectomy in LVO acute ischemic stroke patients (n=39 per protocol; n=26 with complete impedance data).","key_result":"The safety endpoint (no Clotild-related intracranial vessel perforation/dissection) was met in all subjects. Classification of clot composition achieved AUC 0.97 (95% CI 0.93–0.99) for RBCs and 0.94 (95% CI 0.89–0.98) for platelets; detection AUC was 0.69 (95% CI 0.59–0.77) for arterial wall and 0.83 (95% CI 0.59–1.00) for distal clot end.","limitations":"- Performance population was small (n=26) and split into development (n=11) and validation (n=15) subsets, limiting statistical power.\n- Single-arm design with no comparator; performance benchmarked against impedance experts' readings rather than a histopathologic gold standard.\n- Wide confidence interval for distal clot end detection (AUC 0.83, 95% CI 0.59–1.00) reflects substantial uncertainty.","practice_takeaway":"The Clotild Smart Guidewire appears safe and shows strong signal for real-time clot composition classification during thrombectomy, though larger studies are needed before it can reliably guide procedure strategy. Clinicians should note that arterial wall detection performance was moderate (AUC 0.69) and requires further validation."}}],"initialOffset":1,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Impedance-Based Clot Characterization"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Impedance-Based Clot Characterization"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Impedance-Based Clot Characterization"}}}]]

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