Multiple coaxial catheter system for reliable access in interventional stroke therapy.

Area of Science:

• Neurology
• Interventional Neuroradiology
• Medical Devices

Background:

• Navigating complex aortic arch and cerebral vasculature is a significant challenge during mechanical thrombectomy for acute ischemic stroke.
• Existing thrombectomy systems can face limitations in tortuous anatomy, potentially hindering successful revascularization.

Purpose of the Study:

• To describe a novel multiple coaxial catheter system designed to facilitate navigation and manipulation in tortuous vessels.
• To evaluate the safety and efficacy of this system in patients undergoing mechanical thrombectomy for acute ischemic stroke.

Main Methods:

• A triple or quadruple coaxial catheter system was utilized in 28 consecutive acute ischemic stroke cases.
• The system comprised 8-Fr and 6-Fr guiding catheters housing inner reperfusion catheters, navigated over a microcatheter.
• Mechanical thrombectomy was performed using the Penumbra System, with adjunct thrombolysis or angioplasty/stenting as needed.

Main Results:

• The coaxial catheter system successfully provided access to cerebral lesions and stability for complex manipulations, including thromboaspiration and stent navigation in all cases.
• The system enabled diverse interventions, such as carotid stenting and intracranial procedures.
• No complications related to the catheter system were reported in this series.

Conclusions:

• The developed triple or quadruple coaxial catheter system is safe and efficient for mechanical thrombectomy in acute ischemic stroke.
• This system offers improved navigability and stability in tortuous anatomy, enhancing treatment delivery.
• The system's versatility supports various interventional approaches beyond simple thrombectomy.