Introduction/Purpose Aspiration thrombectomy is highly effective for large vessel occlusions (LVOs). This study directly compares aspiration efficiencies of commercially available aspiration catheters at pre-determined, clinically relevant, catheter-to-clot ratios (CCRs). The catheter efficiencies of several commercially available 4F, 5F, and 6F catheters were quantified via benchtop testing by using synthetic clots. The synthetic clots have repeatable physiological mechanical properties and specific sizes (average CCRs: 0.55, 0.58, and 0.48). Smaller CCRs represent more challenging ingestions. Catheter efficiency compares each catheter’s average aspiration time to the longest average aspiration time, per classification.

Materials and Methods Using the Bioengineering Devices Lab (BDL) comprehensive benchtop model, 4F and 5F catheter classifications were placed at the middle cerebral artery (MCA), engaging 2.0–2.4 mm diameter synthetic clots. 6F catheter classifications were placed at the internal carotid artery (ICA) terminus, engaging 3.7 mm diameter synthetic clots. Real time pressure data, recorded during aspiration, helped to quantify: clot ingestion%, aspiration time, and catheter efficiency for each classification.

Results Catheter efficiencies for the 4F, 5F, and 6F classifications were compared (table 1) and p values were computed at 95% confidence. 6 F classification : Compared to the RED 72, the SOFIA Flow Plus (SOFIA 6F) had the highest efficiency (p < 0.01) with a CCR=0.48. JET 7 and Vecta 71 efficiencies were second highest (p < 0.02 and p < 0.04 respectively). Zoom 71, React 71 and RED 68 had statistically equivalent efficiencies. RED 62, CCR=0.42, was overly challenged by 3.7 mm clots. 5 F classification : Zoom 55 had a statistically higher efficiency than the SOFIA 5F (p < 0.01) and equivalent CCRs=0.58. The RED 62, with a less challenging CCR=0.65, trended toward a higher efficiency, but not statistically significant (p = 0.053). 4 F classification : Zoom 45 had a statistically higher efficiency than Vecta 46 (p < 0.01) with a more challenging CCR=0.56. The 4Max had a high efficiency with the most challenging CCR=0.52. Both the 4Max and Red43 had a low clot ingestion%. Overall, the Zoom 45 and Zoom 55 aspiration catheters outperformed other catheters in their classifications, with similar CCRs. 6F catheters were more difficult to differentiate, although the SOFIA 6F had the highest efficiency, with a more challenging CCR.

Conclusion Aspiration efficiency testing is a strong tool to quantify treatment decisions based on CCR. Results are directly relatable to catheter classification placement in stroke-affected vessels of known diameters. Future studies will quantify catheter efficiencies with hard synthetic clots using predetermined CCRs.

Disclosures H. Berns: None. S. Robertson: None. W. Clark: None. K. Lewis: None. J. Wells: None. M. Alnajrani: None. A. Quintero Retis: None. A. Camisa: None. K. Hakes: None. C. Rapoport: None. S. Schwartz: None. T. Becker: 1; C; National Institute of Health.