Introduction Super large-bore catheters (SLBC) with a 0.088’ distal ID may generate greater aspiration force but deliverability is more challenging. The Tenzing 8 (Route 92 Medical, San Mateo, CA) shelf-reducing delivery catheter is designed to permit tracking of HiPoint 088 (Route 92 Medical, San Mateo, CA), a SLBC-extender.

Aim of Study We report our initial experience with this system in the treatment of ICA terminus and M1 occlusions.

Methods Using prospectively maintained institutional databases, we retrospectively reviewed clinical and angiographic data of consecutive patients who underwent off-label aspiration thrombectomy (AT) with Tenzing 8 and HiPoint 088 between 2021-2024.

Results Seventy patients underwent AT with Tenzing 8/HiPoint 088 catheters: 51% female; median age 72(IQR 62-80) years; median baseline NIHSS 19(IQR 14-24); 22 ICA terminus and 48 M1 MCA occlusions. HiPoint 088 was successfully delivered to the target occlusion in 66/70(94%). A leading microwire was not needed to advance the system to the occlusion in 71%. Adjunctive thrombectomy devices were used for secondary/distal occlusions in 21%. The rate of successful revascularization (mTICI ≥ 2b) was 99%. First pass effect mTICI ≥ 2C for M1 occlusions was 65%. Median number of passes was 1 (IQR 1-2); median groin puncture to first pass time was 13(IQR 8-19) minutes with median revascularization time of 21(IQR 16-34) minutes. There were 6 procedural complications (1 cervical ICA dissection, 4 femoral artery occlusions, 1 SAH related to adjunctive device use) and 2 sICH.

Conclusion High catheter delivery and reperfusion rates were achieved using Tenzing 8 and HiPoint 088, with a low complication rate.

Disclosure of Interest yes Fabio Settecase, Warren Kim, Joey English: Consultant and Equity interest in Route 92 Medical. Blaise Baxter: Consultant for Stryker, Medical Device Business Services, Inc.; Honoraria: Penumbra.