Blind exchange with mini-pinning technique for distal occlusion thrombectomy

Area of Science:

• Neurology
• Interventional Neuroradiology
• Vascular Surgery

Background:

• Distal occlusion thrombectomy requires technical advancements for improved efficacy.
• The blind catheter exchange and mini-pinning techniques are introduced for treating distal occlusions.

Purpose of the Study:

• To describe the blind exchange/mini-pinning (BEMP) technique for distal occlusion thrombectomy.
• To evaluate the safety and effectiveness of BEMP compared to standard techniques.

Main Methods:

• Retrospective review of a prospective database (January 2015 - August 2018) for distal occlusions treated with BEMP.
• Detailed description of the BEMP technique involving a Trevo retriever and 3MAX aspiration catheter.
• Comparison of BEMP (n=25) with standard thrombectomy techniques (n=144).

Main Results:

• BEMP was used for distal occlusions, predominantly in distal middle cerebral artery (MCA) segments (M3 occlusions 52% vs 22%).
• Higher rates of first-pass modified Thrombolysis in Cerebral Infarction 2b-3 achieved with BEMP (80% vs 56%, p=0.03).
• Trend towards higher first-pass full reperfusion with BEMP (60% vs 40%, p=0.07); final outcomes were comparable.

Conclusions:

• The BEMP technique is a safe and effective option for treating distal occlusions.
• Further research is recommended to validate these findings.