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MeVO SAVE technique: initial experience with the 167 cm long NeuroSlider 17 for a combined approach in medium vessel
Carlos Pérez-García1, Santiago Rosati2, Carlos Gómez-Escalonilla3
1Interventional Neuroradiology, Hospital Clinico Universitario San Carlos, Madrid, Spain cperezgarcia.med@gmail.com.
Abstract:
Goyal et al described occlusions in M2/3, A2/3 and P2/3 as medium vessel occlusions (MeVOs); the only available controlled data of mechanical thrombectomy (MT) in MeVOs is limited to the middle cerebral artery M2 segment, suggesting that MT may be effective and safe with high functional independence and recanalization rates. The Stent retriever Assisted Vacuum-locked Extraction (SAVE) technique in mechanical thrombectomy consists of the simultaneous use of a stent retriever and a distal aspiration catheter (DAC), with the removal of both as a unit when performing the thrombectomy pass; however, so far the low-profile (0.035 inch distal inner diameter) DACs were longer (160 cm) than conventional 0.017 inch microcatheters for MeVOs. We present a case of a combined approach MT in MeVO with the use of the new 167 cm long NeuroSlider 17 (Acandis, Pforzheim, Germany) 0.0165 inch microcatheter and 3MAX (Penumbra, Alameda, CA) through the SAVE technique-the MeVO SAVE technique. (video 1). neurintsurg;13/8/768/V1F1V1video 1.
Insights
Mechanical thrombectomy (MT) using the Stent retriever Assisted Vacuum-locked Extraction (SAVE) technique is effective for medium vessel occlusions (MeVOs). A novel approach combined a longer microcatheter and aspiration catheter for successful MT in MeVOs.
Area of Science:
- Neurology
- Interventional Neuroradiology
- Vascular Neurology
Background:
- Medium vessel occlusions (MeVOs) affect the M2/3, A2/3, and P2/3 segments.
- Mechanical thrombectomy (MT) data for MeVOs is limited, primarily to the middle cerebral artery M2 segment.
- The Stent retriever Assisted Vacuum-locked Extraction (SAVE) technique involves a stent retriever and distal aspiration catheter (DAC).
Purpose of the Study:
- To present a case of combined approach MT in MeVO using the SAVE technique.
- To describe the use of a new, longer microcatheter with a DAC in the SAVE technique for MeVOs.
Main Methods:
- The study utilized the Stent retriever Assisted Vacuum-locked Extraction (SAVE) technique.
- A new 167 cm long, 0.0165 inch microcatheter (NeuroSlider 17) was used with a 3MAX aspiration catheter.
- This combined approach was applied to a patient with a medium vessel occlusion.
Main Results:
- The described technique, termed "MeVO SAVE technique," was successfully employed.
- The use of a longer microcatheter facilitated the procedure.
- This approach potentially expands MT options for MeVOs.
Conclusions:
- The "MeVO SAVE technique" offers a viable approach for mechanical thrombectomy in medium vessel occlusions.
- The use of extended-length microcatheters and aspiration catheters can enhance procedural success.
- Further research is warranted to evaluate the efficacy and safety of this technique in a larger cohort.
