Title

Super large-bore ingestion of clot (SLIC) leads to high first pass effect in thrombectomy for large vessel occlusion

UMMS Affiliation

Department of Radiology; Division of Neurointerventional Radiology, University of Massachusetts Medical Center; New England Center for Stroke Research

Publication Date

2022-06-22

Document Type

Article

Disciplines

Cardiovascular Diseases | Nervous System Diseases | Neurology | Neurosurgery | Radiology

Abstract

BACKGROUND: Super large-bore aspiration (SLBA) has shown high rates of complete clot ingestion.

OBJECTIVE: To report the initial clinical feasibility, safety, and efficacy of this novel SLBA insert combination-super large-bore ingestion of clot (SLIC) technique for stroke.

METHODS: We performed a retrospective review of three comprehensive stroke center databases. The SLIC technique entails a triaxial assembly of an 8 Fr 0.106'' Base Camp catheter, 0.088'' catheter extender (HiPoint), and an insert catheter (Tenzing 8) that completely consumes the inner diameter of the 0.088'' SLBA catheter. The HiPoint catheter is delivered over the Tenzing 8 to the face of the embolus, which is withdrawn, while aspirating through the Base Camp and HiPoint catheters as a single assembly.

RESULTS: Thirty-three consecutive patients with large vessel occlusion were treated with SLIC. The median age was 70 years (30-91) and 17 were male (51.5%). The median presenting National Institutes of Health Stroke Scale score and Alberta Stroke Program Early CT score was 21 (1-34) and 8 (5-10), respectively. There was 100% success in delivering the 0.088'' catheter to the site of the occlusion. The successful revascularization rate (modified Thrombolysis in Cerebral Infarction (mTICI) score > /=2B) was 100% within a single pass in most cases (82%). Final mTICI > /=2C was achieved in 94.1% of occlusions, with 73.5% mTICI 3 recanalization. The rate of first pass effect in achieving excellent reperfusion (mTICI > /=2C) was 70.5%. There were no adverse events or postprocedural symptomatic hemorrhages.

CONCLUSIONS: Our initial experience with the SLIC technique resulted in achieving a first pass effect (mTICI > /=2C) in 70.5%. Navigation of the SLBA catheter extender over the Tenzing insert was successful and safe in this early experience.

Keywords

Catheter, Intervention, Stroke, Technique

DOI of Published Version

10.1136/neurintsurg-2022-018806

Source

Massari F, Dabus G, Cortez GM, Singh J, Kuhn AL, Naragum V, Anagnostakou V, Hanel RA, Gounis MJ, Puri AS. Super large-bore ingestion of clot (SLIC) leads to high first pass effect in thrombectomy for large vessel occlusion. J Neurointerv Surg. 2022 Jun 22:neurintsurg-2022-018806. doi: 10.1136/neurintsurg-2022-018806. Epub ahead of print. PMID: 35732483. Link to article on publisher's site

Journal/Book/Conference Title

Journal of neurointerventional surgery

Related Resources

Link to Article in PubMed

PubMed ID

35732483

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