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Ischemic stroke
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Efficacy of beveled tip aspiration catheter in mechanical thrombectomy for acute ischemic stroke
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  • Published on: 13 August 2021
    Action mechanism of the beveled tip aspiration catheter
    • Yang Liu, Mechanical Engineer Mayo Clinic-Rochester
    • Other Contributors:
      • David F Kallmes, Interventional Radiologist

    We read with great interest the recent paper by Vargas, et al. describing a novel beveled tip aspiration catheter with improved recanalization and patient outcome compared to conventional non-beveled tip catheters in a single-center retrospective study.[1] We want to express our sincere congratulations to the authors on this finding but also want to respectively present our disagreement on the mechanisms explaining the improved performance of the beveled tip catheter as compared to standard catheters.

    The authors conclude that a primary reason for higher rate of complete clot ingestion for the beveled tip catheter relates to the area of the catheter tip. It is widely accepted that ingestion force predicts recanalization efficacy, and this force is proportional to tip area (A) and pressure drop (P). The authors note that the beveled tip leads to an ovalized tip area with a total tip area that is approximately 15% larger than a catheter with an equivalent inner diameter but standard non-beveled tip. They then propose that this 15% increase in tip area leads to a corresponding increase of ingestion force, using the standard F=A*P equation. However, this proposition is flawed. While it is true the total force is larger for the beveled tip catheter than a standard catheter, this total force includes two separate force components that are orthogonal to each other, including the ingestion force component (along the catheter’s length) that corks or ingests the clot and...

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    Conflict of Interest:
    YL: Consulting: Endovascular Engineering, LLC
    DFK: Ownership/stockholder: Marblehead Medical, LLC, Superior Medical Experts, LLC, NeuroSigma; Research support: MicroVention, Medtronic, NeuroSigma, NeuroVasx, MiVi Neurovascular, Insera Therapeutics; Data Safety Monitoring Board: Vesalio, NoNO