ArticleJournal of neurointerventional surgery2022
Maximizing the catheter-to-vessel size optimizes distal flow control resulting in improved revascularization in vitro for aspiration thrombectomy.
Article in Journal of neurointerventional surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.
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Who cites it
31 citing papers in PubMed, 57 citations in OpenAlex.
- Stroke thrombectomy with a novel reperfusion system including a 0.088'' aspiration catheter: the Imperative Trial.Journal of neurointerventional surgery · 2026Trial
- Why Is a Large-Bore Catheter Necessary in Large Vessel Occlusion from a Biomechanical Perspective?Journal of Korean Neurosurgical Society · 2026Article
- Beyond the Catheter: Contemporary Aspiration Pump Systems in Neurointerventional Stroke Therapy.Stroke (Hoboken, N.J.) · 2026Review
- Multicenter experience of the Monopoint reperfusion system in acute large vessel occlusion stroke thrombectomy.Journal of neurointerventional surgery · 2026Article
- Prognostic value of intracranial vascular tortuosity in thrombectomy for distal vessel occlusion.European stroke journal · 2026Article
- An in vitro assessment of aspiration technologies: Location of conduit for 6F aspiration catheters and design of catheter tip influence clot retrieval success.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025Article
- Balancing flow arrest and aspiration: The relationship between balloon guide catheters, large-bore aspiration, and first pass effect in mechanical thrombectomy.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025Article
- MillipedeInterventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025Article
- Prognostic value of intracranial vascular tortuosity in thrombectomy for distal vessel occlusion.European stroke journal · 2025Article
- Does endovascular thrombectomy using super-bore 0.088" large distal platform offer advantages over balloon guide catheters in acute ischemic stroke secondary to large vessel occlusion?Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025Article
- Impact of next-generation delivery assist catheters and crossing strategy on reperfusion success in aspiration thrombectomy.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025Article
- Tenzing Assisted Delivery of Aspiration (TADA) technique for thrombectomy of medium vessel occlusions using the Freeclimb 54 catheter: multicenter experience.Journal of neurointerventional surgery · 2025Article
- Overcoming the black box of aspiration thrombectomy in acute ischemic stroke: An early clinical experience of using contrast injections to understand clot-catheter interactions.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025Article
- Contact Aspiration Combined with a Stent Retriever versus Contact Aspiration Alone in Mechanical Thrombectomy for Acute Ischemic Strokes: A Nationwide Analysis Using the Diagnosis Procedure Combination Database.Journal of neuroendovascular therapy · 2025Article
- Current Approaches and Methods to Understand Acute Ischemic Stroke Treatment Using Aspiration Thrombectomy.Cardiovascular engineering and technology · 2024Review
- Structural Analysis of Aspiration Catheters and Procedural Outcomes: An Analysis of the SVIN Registry.Stroke (Hoboken, N.J.) · 2024Article
- Variability in Intracranial Vessel Diameters and Considerations for Neurovascular Models: A Systematic Review and Meta-Analysis.Stroke (Hoboken, N.J.) · 2024Article
- First pass effect as an independent predictor of functional outcomes in medium vessel occlusions: An analysis of an international multicenter study.European stroke journal · 2024Article
- Collateral flow and pulsatility during large vessel occlusions: insights from a quantitativeFrontiers in bioengineering and biotechnology · 2024Article
- In vitro models for the experimental evaluation of mechanical thrombectomy devices in acute ischemic stroke.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2023Review
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBalloon guide catheters (BGCs) achieve proximal flow control during thrombectomy but antegrade intracranial flow often persists via the Circle of Willis. Closely sizing an aspiration catheter to the target vessel might achieve greater flow control and improve technical performance. Our objective was to measure the impact of aspiration catheter size on distal flow control and flow reversal with and without the use of BGCs. Clot retrieval testing was performed to establish the impact of these parameters on revascularization.
methodsAn in vitro thrombectomy model replicated in vivo conditions. Flow was measured continuously using ultrasonic flow sensors placed 20 cm distal to the catheter tip in the middlel cerebral artery (MCA). Four aspiration catheters of increasing size were evaluated: ACE 60 and 64 (Penumbra), SOFIA Plus (MicroVention), and Millipede 088 (Perfuze). Two clot analog types (red blood cell-rich and fibrin/platelet-rich) were used for clot retrieval testing.
resultsThe larger area of the 'superbore' Millipede 088 catheter resulted in a larger reduction in antegrade flow than standard aspiration catheters, even when the latter were combined with a BGC. During aspiration, 6Fr catheters were unable to cause flow reversal in the distal MCA while the Millipede 088 achieved significant distal flow reversal (-146 mL/min) (P<0.0001*) (*denotes significance). The solo use of Millipede 088 resulted in better recanalization outcomes and significantly reduced distal emboli for internal carotid artery (P=0.015*) and MCA (P=0.014*) occlusions compared with all other devices and combinations.
conclusionsMaximizing the catheter-to-vessel size facilitates near flow-arrest on catheter insertion, potentially negating the need for a BGC. A 0.088 inch aspiration catheter enables significant flow reversal in the distal MCA during aspiration.
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