Combined Approach to Stroke Thrombectomy Using a Novel Short Flexible Aspiration Catheter with a Stent Retriever

Abstract

Background Large-bore aspiration catheters enabling greater flow rates and suction force for mechanical thrombectomy might improve outcomes in patients with stroke secondary to large-vessel occlusion. Complete or near-complete reperfusion after a single thrombectomy pass (first-pass effect) is associated with improved clinical outcomes. We assessed the efficacy and safety of novel MIVI Q™ aspiration catheters in combination with stent-retriever devices. Methods We retrospectively analyzed demographics, procedure characteristics, and clinical data from consecutive patients with acute anterior large-vessel occlusion treated with a combined approach using MIVI Q™ aspiration catheters and stent retrievers. Reperfusion was defined according to the modified thrombolysis in cerebral infarction (mTICI) score. Clinical outcomes were measured by the National Institute of Health Stroke Scale (NIHSS) and modified Rankin scale (mRS) scores. Results We included 52 patients (median age, 75 y IQR: 64–83); 31 (59.6%) women; 14 (26.9%) with terminal internal carotid artery occlusions, 26 (50%) middle cerebral artery (MCA) segment M1 occlusions, and 12 (23.1%) MCA segment M2 occlusions; median NIHSS score at admission was 19 (IQR: 13–22). After the first pass, 25 (48%) patients had mTICI ≥ 2c. At the end of the procedure, 47 (90.4%) had mTICI ≥ 2b and 35 (67.3%) had mTICI ≥ 2c. No serious device-related adverse events were observed. Symptomatic intracranial hemorrhage developed in 1 patient. Mean NIHSS score was 13 at 24 h and 5 at discharge. At 90 days, 24 (46.2%) patients were functionally independent (mRS 0–2). Conclusion This preliminary study found good efficacy and safety for MIVI Q™ aspiration catheters used in combination with stent-retriever devices.

Thrombectomy aspiration post-market study in acute stroke with the Q aspiration catheter: the TAPAS study

“…In this multicenter clinical study on the novel MIVI Q Aspiration Catheter, we found that the device was technically successful in navigating to the clot in most cases, with rates of first pass and successful recanalization that are preliminarily comparable to other large bore aspiration catheters ( table 4 ). While previous studies have shown the good performance of the Q Catheter when used in combination with SR, 9 these are the first results to demonstrate the feasibility of its use as first-line therapy for AIS.…”

Combined technique as first approach in mechanical thrombectomy: Efficacy and safety of REACT catheter combined with stent retriever

“…The benefit of larger DAC diameter and its balance with navigability continues to be explored in prospective studies focused on new larger-diameter catheters such as Zoom 88 26 or ANA. 27 In the same way, the effect of new delivery or navigability systems such as Tenzing 28 or MIVIQ 29 will be evaluated in prospective studies. Moreover, the use of balloon guide catheters has been shown to improve the rate of FPE 11 , 30 , 31 and reduce distal emboli.…”