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Abstract
Introduction The introduction of flexible distal access super bore catheters, 0.088’ or larger inner diameter (SBCs) has increased the armamentarium available for Mechanical Thrombectomy (MT) in patients with Acute Ischemic Stroke (AIS). Herein, we report on our initial experience with the Sofia 0.088 inch SBC (S8SBC, Microvention, CA) in the management of patients with AIS.
Materials and Methods The S8SBC was used in MT for AIS in 14 patients (8 female, 6 male, mean age 59.8 ± 16. 9 years). In 13 patients, the S8SBC was advanced through a short 8 F femoral sheath into the ipsilateral ICA over a glide wire after the CCA origin was selected with a 5F selection catheter, it was then advanced further into the occluded ICA or MCA over a smaller intermediate aspiration catheter (Sofia 6F or Zoom 0.055’), except in one patient in whom it was snaked primarily into the MCA. In one patient, the S8SBC was exchanged for a Balloon guide catheter due to lack of stability in the CCA.
Results The occluded vessel was Left M1 in 6, Right M1 in 6, and Left ICA and M1 in 1 patient, among the 13 in whom S8SBC was used. Median admission NIHSS = 14, Median ASPECTS = 9, median pre-AIS mRS = 0, and median last Known well = 6 hours (0.5 to 72 hours range). In 8 patients, a stent retriever and a 6F aspiration catheter were tried first, prior to advancing the S8SBC to the face of the clot. In 2 patients, aspiration was attempted through a 6F catheter first, and in 3 patients, aspiration through the S8SBC was performed as the first line. After a median of 2 passes, mTICI 3 was achieved in 7 patients, 2b in 3, 2 c in 2, and 2a in one patient with distal vessel stenosis. All 3 patients with primary S8SBC aspiration had TICI 3 scores with a single pass. Three patients died during admission: for the rest, median discharge NIHSS = 4, median mRS at discharge = 2. No S8SBC related complications were noted.
Conclusion The S8SBC is a promising addition to the armamentarium for MT in AIS. It could be safely navigated to the site of vessel occlusion through a short femoral sheath and seems effective in this small series.
Showing S8SBC in distal left M1
Disclosures B. Jagadeesan: 1; C; Microvention. 2; C; Microvention, Medtronic, Stryker, Boston Scientific. D. Qaryouti: None. A. Grande: 2; C; Microvention, Medtronic. R. Tummala: None.