Initial experience with SOFIA as an intermediate catheter in mechanical thrombectomy for acute ischemic stroke

Area of Science:

• Neurology
• Interventional Neuroradiology
• Medical Devices

Background:

• Mechanical thrombectomy is a proven treatment for emergent large vessel occlusion (ELVO).
• Established techniques like Solumbra and ADAPT require intermediate catheters for clot suction.
• The SOFIA catheter, a new flexible, reinforced catheter, needed evaluation for its role in mechanical thrombectomy.

Purpose of the Study:

• To assess the initial clinical experience with the SOFIA catheter in acute stroke interventions.
• To evaluate the efficacy and safety of SOFIA for mechanical thrombectomy in ELVO.

Main Methods:

• A retrospective review of 33 patients with ELVO undergoing endovascular stroke intervention using the SOFIA catheter.
• Data collected included demographics, clinical presentation, treatment details, and complications.
• Primary outcomes were Thrombolysis in Cerebral Infarction (TICI) 2b/3 revascularization rates and number of passes; secondary outcomes included complication rates and discharge NIHSS scores.

Main Results:

• 94% TICI 2b/3 revascularization was achieved in 33 patients (mean age 72), with 48.5% achieving TICI 3.
• The average number of passes was 1.6, with the Solumbra technique used in 94% of cases.
• Symptomatic reperfusion hemorrhage occurred in 6%, and procedural complications were unrelated to SOFIA; mortality was 21%.

Conclusions:

• Mechanical and aspiration thrombectomy using the SOFIA catheter is safe and effective for ELVO.
• The SOFIA catheter's trackability, stability, and lumen size support its use in stroke intervention.
• High revascularization rates indicate SOFIA's potential as a valuable tool in acute stroke treatment.