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Original research
MRS SOFIA: a multicenter retrospective study for use of Sofia for revascularization of acute ischemic stroke
  1. Waleed Brinjikji1,
  2. Eytan Raz2,
  3. Reade De Leacy3,
  4. Dan Meila4,
  5. Maxim Mokin5,
  6. Edgar A Samaniego6,
  7. Maksim Shapiro7,
  8. Devin Bageac3,
  9. Alberto Varon6,
  10. Zeguang Ren5,
  11. Lorenzo Rinaldo8,
  12. Harry J Cloft9
  1. 1Mayo Clinic Minnesota, Rochester, Minnesota, USA
  2. 2Department of Radiology, NYU, New York, New York, USA
  3. 3Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
  4. 4Department of Radiology and Neuroradiology, Klinikum Duisburg - Sana Kliniken, Duisburg, Germany
  5. 5Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, Florida, USA
  6. 6Interventional Neuroradiology/Endovascular Neurosurgery Division Department of Neurology, Neurosurgery and Radiology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
  7. 7Department of Interventional Radiology, New York University Langone Medical Center, New York, New York, USA
  8. 8Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA
  9. 9Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
  1. Correspondence to Dr Waleed Brinjikji, Mayo Clinic Minnesota, Rochester, Minnesota, USA; Brinjikji.Waleed{at}


Background Over the past several years there has been increased interest in the use of the Sofia aspiration system (MicroVention, Tustin, California) as a primary aspiration catheter.

Objective To perform a multicenter retrospective study examining the efficacy of the Sofia aspiration catheter as a standalone aspiration treatment for large vessel occlusion.

Methods Consecutive cases in which the Sofia catheter was used for aspiration thrombectomy for large vessel occlusion were included. Exclusion criteria were the following: (1) Sofia not used for first pass, and (2) a stent retriever used as an adjunct on the first pass. The primary outcome of the study was first pass recanalization (Thrombolysis in Cerebral Infarction (TICI) 2c/3). Secondary outcomes included first pass TICI 2b/3, crossover to other thrombectomy devices, number of passes, time from puncture to recanalization, and complications.

Results 323 patients were included. First pass TICI 2c/3 was achieved in 49.8% of cases (161/323). First pass TICI 2b/3 was achieved in 69.7% (225/323) of cases. 74.8% had TICI 2b/3 with the Sofia alone. Crossover to other thrombectomy devices occurred in 29.1% of cases (94/323). The median number of passes was 1 (IQR=1–3). Median time from puncture to recanalization was 26 min (IQR=17–45). Procedure related complications occurred in 3.1% (10/323) of cases.

Conclusion Our study highlights the potential advantage of the Sofia aspiration catheter for primary aspiration thrombectomy in acute ischemic stroke. High rates of first pass recanalization with low crossover rates to other thrombectomy devices were achieved. Median procedure time was low, as were procedural complications.

  • stroke
  • thrombectomy

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  • Twitter @wbrinjikji, @rdeleacymd

  • Contributors All authors contributed to data collection and analysis. All authors made critical revisions to the manuscript. All authors contributed to study design. WB drafted the original manuscript.

  • 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 WB is a consultant and proctor for MicroVention. Money paid to institution <$10 000.

  • Patient consent for publication Not required.

  • Ethics approval Mayo Clinic IRB 20–1756.

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

  • Data availability statement No data are available.

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