RT Journal Article SR Electronic T1 Experimental evaluation of direct thromboaspiration efficacy according to the angle of interaction between the aspiration catheter and the clot JF Journal of NeuroInterventional Surgery JO J NeuroIntervent Surg FD BMJ Publishing Group Ltd. SP 1152 OP 1156 DO 10.1136/neurintsurg-2020-016889 VO 13 IS 12 A1 Gianmarco Bernava A1 Andrea Rosi A1 José Boto A1 Jeremy Hofmeister A1 Olivier Brina A1 Philippe Reymond A1 Michel Muster A1 Hasan Yilmaz A1 Zsolt Kulcsar A1 Emmanuel Carrera A1 Mohamed Bouri A1 Karl-Olof Lovblad A1 Paolo Machi YR 2021 UL http://jnis.bmj.com/content/13/12/1152.abstract AB Background Successful direct thromboaspiration (DTA) is related to several factors such as clot consistency, size, and location. It has also been demonstrated recently that the angle of interaction (AOI) formed by the aspiration catheter and the clot is related to DTA efficacy. The aims of this study were three-fold: (a) to confirm the clinical finding that the AOI formed by the aspiration catheter and the clot influence DTA efficacy; (b) to evaluate to what extent this influence varies according to differences in clot consistency and size; and (c) to validate stent retriever thrombectomy as an effective rescue treatment after DTA failure in the presence of an unfavorable AOI.Methods A rigid vascular phantom designed to reproduce a middle cerebral artery trifurcation anatomy with three M2 segments forming different angles with M1 and thrombus analog of different consistencies and sizes was used.Results DTA was highly effective for AOIs >125.5°, irrespective of thrombus analog features. However, its efficacy decreased for acute AOIs. Rescue stent retriever thrombectomy was effective in 92.6% of cases of DTA failure.Conclusions This in vitro study confirmed that the AOI formed by the aspiration catheter and the thrombus analog influenced DTA efficacy, with an AOI >125.5° related to an effective DTA. Stent retriever thrombectomy was an effective rescue treatment after DTA failure, even in the presence of an unfavorable AOI.All data are available upon request to the corresponding author.