Introduction/Purpose Traditional approaches to aspiration mechanical thrombectomy include use of a leading inner microcatheter and microwire construct to deliver an aspiration catheter to the occlusion. The Tenzing 7 Delivery Catheter (T7, Route 92 Medical, San Mateo, CA), which is designed to deliver an 0.070 inch inner diameter aspiration catheter to the MCA M1 segment, is compatible with 0.014 and 0.016 inch microwires, though early experience suggests that a leading microwire is often not needed. The aim of this study is to compare successful delivery and outcomes of aspiration thrombectomy using the T7 catheter with and without a microwire.

Materials and Methods Across four institutions, a retrospective analysis was conducted of 89 patients (2020-2022) who underwent successful single pass aspiration mechanical thrombectomy (mTICI score >= 2B) using the Tenzing 7 Delivery Catheter. Primary efficacy outcomes compared the rate of successful delivery to the occlusion site and groin to revascularization time between procedures with and without a leading microwire. Quantitative variables were analyzed using Student’s two sample t-test, and qualitative variables were analyzed with chi-square tests. Significance level was set at 0.05. Results: The Tenzing 7 catheter delivery device was used without a microwire in 70/89 (79%) of patients. The rate of successful catheter delivery with T7 to the occlusion on first pass was similar with and without use of a microwire (97% without a microwire, 89% with a microwire, p=0.15). Median groin to revascularization times were comparable between wire and wireless procedures, 17 vs. 16 min, respectively, (p=0.12). No complications were reported with microwire use. Amongst wireless procedures, one (1.4%) patient had T7-related vasospasm, one (1.4%) patient had a femoral site hematoma, and two (2.9%) patients had distal vessel re-occlusions due to underlying stenosis.

Conclusions Rates of successful catheter delivery using the Tenzing 7 device amongst single pass aspiration thrombectomies were similar with and without the use of microwires. The majority of cases did not require a microwire. T7 thrombectomies without microwires were functionally noninferior to procedures using a microwire; the former is more cost-effective as fewer devices are used. From a technique standpoint, initial pass with T7 can be performed without use of microwire, reserving microwire use for refractory cases or known difficult-to-navigate vasculature.

Disclosures M. Koneru: None. D. Tonetti: None. J. English: 2; C; Route 92 Medical, Stryker. F. Settecase: 2; C; Route 92 Medical, Stryker. M. Bhattacharyya: None. P. Patel: None. A. Thomas: None. T. Jovin: 1; C; Stryker, Medtronic. 2; C; Anaconda, Route 92 Medical, VizAI, FreeOx, Methinks, Blockade Medical. 4; C; Corindus. 6; C; Cerenovus, Contego. W. Kim: 2; C; Route 92 Medical, Stryker. M. Abdalkader: None. T. Nguyen: 1; C; Medtronic, SVIN. P. Klein: None. R. Hanel: 1; C; National Institutes of Health, Interline Endowment, Microvention, Stryker, CNX. 2; C; Medtronic, Stryker, Cerevnovous, Microvention, Balt, Phenox, Rapid Medical, Q’Apel. 4; C; InNeuroCo, Cerebrotech, eLum, Endostream, Three Rivers Medical Inc, Scientia, LisT, BlinkTBI, Cornidus. 6; C; MIVI, eLum, Three Rivers, Shape Medical, Cornidus. V. Benalia: None. G. Cortez: None. A. Aghaebrahim: None. E. Sauvageau: 3; C; Stryker. A. Dmytriw: None. H. Shaikh: None.