Initial Experience in Direct Aspiration Thrombectomy Using a Novel 0.071-Inch Aspiration Catheter

World Neurosurg. 2019 Jun:126:272-275. doi: 10.1016/j.wneu.2019.03.055. Epub 2019 Mar 14.

Abstract

Introduction: A Direct Aspiration First Pass Technique is one of the most widely used techniques in mechanical thrombectomy. Aspiration catheter size plays a major role in the success of this technique. The AXS Vecta (Stryker Neurovascular, Fremont, California, USA) aspiration catheter is the first approved 0.071-inch catheter for mechanical thrombectomy. Here, we report our initial experience with direct aspiration thrombectomy using the AXS Vecta aspiration catheter.

Methods: We reviewed the prospectively collected database of all consecutive patients with stroke who underwent thrombectomy using A Direct Aspiration First Pass Technique with the AXS Vecta aspiration catheter at our institution between September 26 and October 12, 2018.

Results: A total of 10 thrombectomy procedures were performed. Of those, 3 patients had M1 occlusion, 6 patients had M2 occlusion, and 1 patient had cervical carotid + M1 tandem occlusion. Modified Thrombolysis in Cerebral Ischemia grade 2b or greater revascularization was obtained in 9 of 10 patients. Median groin-to-reperfusion time was 29.5 (interquartile range 14.25-53.25) minutes. An intermediate catheter (3 Max) was used in all cases. No procedural complications or vascular injury were identified. The AXS Vecta catheter demonstrated excellent tractability and navigability in all cases except 1 case with severe narrowing of M1 segment secondary to atherosclerosis.

Conclusions: In this early experience with the new AXS Vecta aspiration catheter, the catheter was safely navigated to the target vessel even at the level of M2 segment.

Keywords: Aspiration catheter; Hemorrhage; Safety; Stroke; Thrombectomy.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Brain Ischemia / diagnostic imaging
  • Brain Ischemia / surgery*
  • Catheters
  • Cerebral Angiography
  • Female
  • Humans
  • Male
  • Stroke / diagnostic imaging
  • Stroke / surgery*
  • Thrombectomy / instrumentation*
  • Thrombectomy / methods
  • Treatment Outcome