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Abstracts
Ischemic
2.3. Treatment
O08 Medium vessel occlusion aspiration thrombectomy using freeclimb 54 catheter delivered by tenzing 5: early multicenter clinical experience
Free
  1. Fabio Settecase1,2,
  2. Ajit Puri3,
  3. Ronald Budzik4,
  4. Peter Pema4,
  5. Rajkamal Khangura5,
  6. Warren Kim1,2,
  7. Nicholas Telischak6,
  8. Ben McGuinness7,
  9. Shane Lee7,
  10. Matthew Alexander5,
  11. Jasmeet Singh3,
  12. Anna Kuhn3,
  13. Jaehyun Kim1,
  14. Joey English1,2,
  15. James Caldwell7
  1. 1California Pacific Medical Center, San Francisco, USA
  2. 2Mills Peninsula Medical Center, Burlingame, USA
  3. 3UMass Memorial Medical Center, Worcester, USA
  4. 4OhioHealth Riverside Methodist Hospital, Columbus, USA
  5. 5Sutter Sacramento Medical Center, Sacramento, USA
  6. 6Stanford University Medical Center, Stanford, USA
  7. 7Auckland City Hospital, Auckland, New Zealand

Abstract

Introduction Medium-vessel occlusions (MeVO) of the M2/3, A2/3, and P2/3 account for 25%–40% of acute ischemic stroke (AIS). The FreeClimbTM 54 catheter (distal 0.054 inch ID and a 1.7 mm distal OD) is packaged with a specialized delivery catheter, Tenzing® 5 (Route 92 Medical, San Mateo, CA).

Aim of Study We report our initial off-label experience using the FreeClimb 54 and Tenzing 5 in MeVO AIS.

Methods After local IRB approvals, we retrospectively reviewed consecutive patients who underwent off-label MeVO AT with the FreeClimb 54 and Tenzing 5 at 7 institutions from 09/2023-03/2024.

Results Thirty nine patients were treated, 70 ± 18 years old; 21(54%) of which were female. There were 27(69%) primary MeVO and 12(31%) secondary MeVO. Freeclimb 54 was successfully delivered over Tenzing 5 to the target in 39/39(29 M2, 4 M3, 1 M1, 2 A2, 1 A3, 2 P2). Average target vessel diameter was 1.6±0.3 mm on DSA. No stent-retrievers were used for FreeClimb 54 delivery. A stent-retriever was used for an additional thrombectomy pass (2%). A leading microwire was used to advance the Tenzing in 34/39(87%). Primary MeVO mTICI 2C/3 reperfusion was achieved in 21/27(78%) after a median of 1(IQR 1-1) pass, with first pass effect (2C/3) in 21/27(78%). We observed low grade vasospasm in 7/39(18%); one transient carotid-cavernous fistula; one symptomatic intracranial hemorrhage (1/39, 3%) involving a pass in a 1.0 mm diameter M3 segment.

Conclusion Initial clinical experience supports access to intracranial MeVO using Tenzing 5 and FreeClimb 54, for rapid and effective reperfusion with low complication rate.

Disclosure of Interest yes Consultant: Route 92 medical, Stryker; Equity interest: Route 92 Medical.

https://doi.org/10.1136/jnis-2024-ESMINT.8

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