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Ischemic stroke
Original research
Efficacy of beveled tip aspiration catheter in mechanical thrombectomy for acute ischemic stroke
  1. Jan Vargas1,
  2. Jonathan Blalock2,
  3. Anand Venkatraman1,
  4. Vania Anagnostakou3,
  5. Rrobert M King3,
  6. Joseph A Ewing1,
  7. Matthew J Gounis3,
  8. Raymond D Turner1,
  9. Imran Chaudry1,
  10. Aquilla Turk1
  1. 1Neurosurgery, Prisma Health Upstate, Greenville, South Carolina, USA
  2. 2University of South Carolina School of Medicine Greenville Campus, Greenville, South Carolina, USA
  3. 3Department of Radiology, New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, Massachusetts, USA
  1. Correspondence to Dr Jan Vargas, Neurosurgery, Prisma Health Upstate, Greenville, South Carolina, USA; jvargas.machaj{at}prismahealth.org

Abstract

Background Direct aspiration thrombectomy techniques use large bore aspiration catheters for mechanical thrombectomy. Several aspiration catheters are now available. We report a bench top exploration of a novel beveled tip catheter and our experience in treating large vessel occlusions (LVOs) using next-generation aspiration catheters.

Methods A retrospective analysis from a prospectively maintained database comparing the bevel shaped tip aspiration catheter versus non-beveled tip catheters was performed. Patient demographics, periprocedural metrics, and discharge and 90-day modified Rankin Scale (mRS) scores were collected. Patients were divided into two groups based on which aspiration catheter was used.

Results Our data showed no significant difference in age, gender, IV tissue plasminogen activator administration, admission NIH Stroke Scale score, baseline mRS, or LVO location between the beveled tip and flat tip groups. With the beveled tip, Thrombolysis in Cerebral Infarction (TICI) 2C or better recanalization was more frequent overall (93.2% vs 74.2%, p=0.017), stent retriever usage was lower (9.1% vs 29%, p=0.024), and patients had lower mRS on discharge (median 3 vs 4, p<0.001) and at 90 days (median 2 vs 4, p=0.008).

Conclusion Patients who underwent mechanical thrombectomy with the beveled tip catheter had a higher proportion of TICI 2C or better and had a significantly lower mRS score on discharge and at 90 days.

  • device
  • intervention
  • stroke
  • thrombectomy

https://doi.org/10.1136/neurintsurg-2020-016695

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    Footnotes

    • Contributors JV, JB, and AV collected the data and drafted and revised the paper. VA, RMK, and MJG performed the benchtop experiment as well as revised the draft paper. JAE performed the statistical analysis and reviewed the paper. RDT, IC, and AT revised the draft paper.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests JV is a consultant for Integra Life Sciences and Corindus Vascular Robotics. MJG has received research support from the National Institutes of Health (NIH), the United States – Israel Binational Science Foundation, Anaconda, Apic Bio, Arsenal Medical, Axovant, Cerenovus, Ceretrieve, Cook Medical, Galaxy LLC, Gentuity, Imperative Care, InNeuroCo, Insera, Magneto, Microvention, Medtronic Neurovascular, MIVI Neurosciences, Neuravi, Neurogami, Philips Healthcare, Progressive Neuro, Rapid Medical, Route 92 Medical, Stryker Neurovascular, Syntheon, ThrombX Medical and the Wyss Institute; is a consultant on a fee-per-hour basis for Cerenovus, Imperative Care, Medtronic Neurovascular, Mivi Neurosciences, Phenox, Q’Apel Medical, Route 92 Medical, and Stryker Neurovascular; holds stock in Imperative Care, InNeuroCo, and Neurogami. RDT is a consultant for Siemens Healthineers, Johnson and Johnson, Q’Apel Medical, Rebound Therapeutics, Echovate, Viseon; holds stock in Q’Apel Medical, Rebound Therapeutics, Echovate, Viseon, Synchron, Endostream Medical, and receives royalty fees from the Medical University of South Carolina. IC is a consultant for Terumo Microvention, Johnson and Johnson, Imperative Care, Medtronic Neurovascular; holds stock in Q’Apel Medical, RIST Neurovascular, Echovate, Viseon, Synchron, Endostream Medical, and receives royalty fees from the Medical University of South Carolina. AT is a consultant for Blockade Medical, Cardinal Consulting, Cerebrotech, Corindus Vascular Robotics, Medtronic Neurovascular, Endostream Medical, Terumo Microvention, Penumbra, Siemens Healthineers, Imperative Care, Three Rivers Medical, Vastrax, Shape Memory, Stryker Neurovascular, Serenity Medical, 880 Medical, Q’Apel Medical; holds stock in Cerebrotech, Corindus Robotics, Endostream Medical, Imperative Care, Three Rivers Medical, Vastrax, Shape Memory, Synchron, Serenity Medical, BlinkTBI, Echovate, RIST, Apama, Pipe Therapeutics; is the Chief Medical Officer of Corindus Robotics, Imperative Care; is the co-founder of Imperative Care, Vastrax, National Education and Research (NEAR) Center, Neuro Technology Investors (NTI), Pipe Therapeutics; is a board member of BlinkTBI.

    • Patient consent for publication Not required.

    • Ethics approval Prisma Health Upstate IRB - Pro00103652.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon reasonable request. Please contact the corresponding author for data requests.

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