Super-large bore catheter in the treatment of large vessel occlusions: initial multicenter experience
Edgar A. Samaniego, Andres Gudino, Leonardo Cruz‐Criollo, Carlos Dier, Brian T. Jankowitz, Aishwarya Aggarwal, Haralabos Zacharatos, Alhamza R Al‐Bayati, Raul G. Nogueira, Mohamed Fahmy Doheim, Shahram Majidi, Michael T. Froehler, Mir Amaan Ali, Ramesh Grandhi, Santiago Gomez‐Paz, Jaydevsinh Dolia, Jonathan A Grossberg, Vinay Jaikumar, Adnan Siddiqui, Ajit S Puri, Raymond Catton, Jasmeet Singh, SoHyun Boo, Mohamad Ezzeldin, Santiago Ortega‐Gutiérrez, Fawaz Al‐Mufti
Abstract
PURPOSE: Large bore catheters are increasingly used in mechanical thrombectomy (MT) for large vessel occlusions (LVOs). OBJECTIVE: To evaluate the efficacy and safety of the super-large bore Cereglide 0.092" (C-92) catheter, featuring the largest inner diameter available. METHODS: A multicenter observational study was conducted across 12 comprehensive stroke centers in the United States. Efficacy outcomes included the first pass effect (FPE) and successful reperfusion. FPE was defined as a first MT pass achieving a modified Treatment in Cerebral Infarction (mTICI) score of ≥2c. Successful reperfusion was defined as final mTICI score ≥2c. Safety outcomes involved device-related complications, symptomatic intracranial hemorrhage (sICH), and inpatient mortality. Functional outcomes included modified Rankin Scale (mRS) score at discharge and delta National Institutes of Health Stroke Scale (NIHSS) score. RESULTS: Fifty patients were included. The most common LVO was the first segment of the middle cerebral artery in 31/50 cases (62%). The C-92 reached the thrombus in 41 patients (82%). Median puncture-to-thrombus and puncture-to-reperfusion times were 15 min (IQR 10-25) and 26 min (IQR 15-49), respectively. FPE was achieved in 25/50 (50%) cases, and in 25/41 (61%) cases when the C-92 reached the thrombus. Successful reperfusion occurred in 36/41 patients (88%). There were no vessel perforations, or sICH. Distal embolization occurred in 4/50 (8%) cases, and 4/50 (8%) died. The mRS score at discharge was 3 (IQR 2-6), and the delta NIHSS score was 8 (IQR 5-12). CONCLUSION: The C-92 catheter demonstrated a safe profile achieving an overall FPE rate of 50%, and favorable functional outcomes in 88% of cases.