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

Abstract

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. 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. 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. 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.