Initial experience with SOFIA as an intermediate catheter in mechanical thrombectomy for acute ischemic stroke

Wong, J; M., Huy; Telischak, N; Moraff, A; Dodd, Robert; Marks, Michael P.; Ingle, Shreya M; Heit, Jeremy J

doi:10.1136/neurintsurg-2016-012750

Cited by 30 publications

(19 citation statements)

References 22 publications

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“…The enlarged inner lumen of the FG2 allowed for concomitant use of intermediate large-bore aspiration catheters for salvage techniques, as well as increased aspiration power. In previous studies, the use of an intermediate catheter and the 'Solumbra technique' have been reported to result in better clinical and radiological outcomes (20,21). Moreover, in the present study, the multivariate analysis revealed that the use of an intermediate catheter reduced the occurrence of distal emboli.…”

Section: Discussionsupporting

confidence: 66%

Comparison of FlowGate2 and Merci as balloon guide catheters used in mechanical thrombectomies for stroke intervention

Lee

Sung

2020

Exp Ther Med

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Section: Discussionsupporting

confidence: 66%

Comparison of FlowGate2 and Merci as balloon guide catheters used in mechanical thrombectomies for stroke intervention

Lee

Sung

2020

Exp Ther Med

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“…Our final rate of favorable mTICI (Ն2b) appears similar to those previously published because authors noted favorable recanalization rates between 86.9% and 94.1% with the Sofia catheter. [8][9][10][11] Gory et al 16 reported 89% of mTICI 2b/3 in a meta-analysis of the overall literature dealing with ADAPT using various kinds of DACs. In comparison, reperfusion rates among ADAPT major trails were 92% and 85.4%, respectively, in the COMPASS and ASTER trials.…”

Section: Angiographic Outcomementioning

confidence: 99%

“…Its braid and coil construction combines different softness segments with a distal inner lumen of 0.055-0.070 inches, respectively, in 5F and 6F Plus versions. Despite previous publications, [8][9][10][11] the safety and efficacy of this DAC in a large population with first-line Sofia use are yet to be reported.…”

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confidence: 92%

First-Line Sofia Aspiration Thrombectomy Approach within the Endovascular Treatment of Ischemic Stroke Multicentric Registry: Efficacy, Safety, and Predictive Factors of Success

Marnat¹,

Barreau²,

Détraz³

et al. 2019

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: After publications on the effectiveness of mechanical thrombectomy by stent retrievers in acute ischemic stroke with large-vessel occlusion, alternative endovascular approaches have been proposed using first-line aspiration catheters. Several devices are currently available to perform A Direct Aspiration First Pass Technique. The Sofia catheter aspiration has been widely used by interventionalists, but data are scarce about its efficacy and safety. Our aim was to report our multicenter thrombectomy experience with first-line Sofia catheter aspiration and to identify independent prognostic factors of clinical and procedural outcomes. MATERIALS AND METHODS: We performed a retrospective analysis of the prospectively maintained Endovascular Treatment of Ischemic Stroke multicentric registry. Data from consecutive patients who benefited from thrombectomy with a first-line Sofia approach between January 2013 and April 2018 were studied. We excluded other first-line approaches (stent retriever or combined aspiration and stent retriever) and extracranial occlusions. Baseline characteristics, procedural data, and angiographic and clinical outcomes were analyzed. RESULTS: During the study period, 296 patients were treated. Mean age and initial NIHSS score were, respectively, 69.5 years and 16. Successful reperfusion, defined by the modified TICI 2b/3, was obtained in 86.1% (n ϭ 255; 95% CI, 81.7%-89.9%). Complete reperfusion (modified TICI 3) was obtained in 41.2% (n ϭ 122; 95% CI, 35.5%-47.1%). A first-pass effect was achieved in 24.2% (n ϭ 71; 95% CI, 19.4%-29.6%). A rescue stent retriever approach was required in 29.7% (n ϭ 88; 95% CI, 24.6%-35.3%). The complication rate was 9.5% (n ϭ 28; 95% CI, 6.4%-13.5%). Forty-three percent (n ϭ 122; 95% CI, 37.1%-48.9%) of patients presented with a favorable 3-month outcome (mRS Յ 2). Older age, M1-occlusion topography, and intravenous thrombolysis use prior to thrombectomy were independent predictors of the first-pass effect. CONCLUSIONS: The first-line contact aspiration approach appeared safe and efficient with Sofia catheters. These devices achieved very high reperfusion rates with a low requirement for stent retriever rescue therapy, especially for M1 occlusions. ABBREVIATIONS: ADAPT ϭ A Direct Aspiration First Pass Technique; DAC ϭ distal aspiration catheter; ETIS ϭ Endovascular Treatment of Ischemic Stroke; FPE ϭ first-pass effect; IQR ϭ interquartile range; IVT ϭ intravenous thrombolysis; mTICI ϭ modified TICI; PH ϭ parenchymal hematoma

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“…Intermediate catheters have been used as an effective system in various neurovascular procedures such as brain arteriovenous malformation embolization [ 5 6 12 ], the intracranial stenting procedure, or aneurysm embolization [ 2 4 8 9 ]. These catheters have been successfully used in various intra-arterial revascularization procedures as an aspiration catheter system or an effective intermediate catheter system for the delivery of stentrievers [ 13 14 15 16 ]. However, these catheters are not suitable to use as a sole guiding catheter system due to the lack of a sufficient supportive body segment.…”

Section: Discussionmentioning

confidence: 99%

Optimal Guiding Catheter Length for Endovascular Coiling of Intracranial Aneurysms in Anterior Circulation in Era of Flourishing Distal Access System

et al. 2017

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PurposeTo determine the minimum required guiding catheter length for embolization of various intracranial aneurysms in anterior circulation and to analyze the effect of various patient factors on the required catheter length and potential interaction with its stability.Materials and MethodsFrom December 2016 to March 2017, 90 patients with 93 anterior circulation aneurysms were enrolled. Three types of guiding catheters (Envoy, Envoy DA, and Envoy DA XB; Codman Neurovascular, Raynham, MA, USA) were used. We measured the in-the-body length of the catheter and checked the catheter tip location in the carotid artery. We analyzed factors affecting the in-the-body length and stability of the guiding catheter system.ResultsThe average (±standard deviation) in-the-body length of the catheter was 84.2±5.9 cm. The length was significantly longer in men (89.1±5.6 vs. 82.1±4.6 cm, P<0.001), patients older than 65 years (87.7±7.8 vs. 82.7±4.2 cm, P<0.001), patients with a more tortuous arch (arch type 2 and 3) (87.5±7.4 vs. 82.7±4.4 cm, P<0.001), and patients with a distal aneurysm location (distal group) (86.2±5.0 vs. 82.7±6.1 cm, P=0.004). A shift in the tip location was noted in 19 patients (20.4%); there was no significant different among the 3 catheters (P=0.942).ConclusionThe minimum required length of a guiding catheter was 84 cm on average for elective anterior-circulation aneurysm embolization. The length increased in men older than 65 years with a more tortuous arch. We could reach a higher position with distal access catheters with little difference in the stability once we reached the target location.

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Initial experience with SOFIA as an intermediate catheter in mechanical thrombectomy for acute ischemic stroke

Abstract: Mechanical and aspiration thrombectomy with SOFIA is safe and effective with high revascularization rates. Its trackability, stability, and luminal size make SOFIA suitable for stroke intervention.

Cited by 30 publications

References 22 publications

Comparison of FlowGate2 and Merci as balloon guide catheters used in mechanical thrombectomies for stroke intervention

Comparison of FlowGate2 and Merci as balloon guide catheters used in mechanical thrombectomies for stroke intervention

First-Line Sofia Aspiration Thrombectomy Approach within the Endovascular Treatment of Ischemic Stroke Multicentric Registry: Efficacy, Safety, and Predictive Factors of Success

Optimal Guiding Catheter Length for Endovascular Coiling of Intracranial Aneurysms in Anterior Circulation in Era of Flourishing Distal Access System

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