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Updated: Nov 4, 2025
Simulator Training for Endovascular Neurosurgery
Published on: May 6, 2020
Comparative study of intracranial access in thrombectomy using next generation 0.088 inch guide catheter technology
Devin V Bageac1, Blake S Gershon1, Jan Vargas2
1Department of Neurosurgery, Mount Sinai Health System, New York, New York, USA.
Insights
A novel 0.088 inch guide catheter, TracStar LDP, demonstrates safety and efficacy in stroke thrombectomy. It significantly reduces time to clot engagement and achieves intracranial access, improving patient outcomes.
Area of Science:
- Neuroendovascular intervention
- Cerebrovascular disease management
- Medical device innovation
Background:
- Conventional 0.088 inch guide catheters pose challenges for safe intracranial navigation during stroke treatment.
- Evaluating novel devices is crucial for advancing thrombectomy procedures.
Purpose of the Study:
- To assess the safety and effectiveness of the TracStar Large Distal Platform (LDP) guide catheter for intracranial navigation in stroke thrombectomy.
- To compare the TracStar LDP with existing guide catheters in terms of technical outcomes and complications.
Main Methods:
- A multicenter retrospective study compared patients undergoing thrombectomy with TracStar LDP versus conventional guide catheters.
- Outcomes analyzed included device-related complications, guide catheter failure, and time to clot engagement.
- Patients with anterior circulation large vessel occlusions were included.
Main Results:
- The TracStar LDP group showed non-inferiority in device-related complications (6.8% vs 8.9%).
- Time to clot engagement was significantly shorter with TracStar LDP (14.29 min vs 23.18 min).
- Successful intracranial access was achieved in 73.33% of cases, with 95.56% successful reperfusion.
Conclusions:
- The TracStar LDP is a safe and effective guide catheter for stroke thrombectomy.
- Its use is associated with reduced time to clot engagement and reliable intracranial access.
- The device facilitates improved procedural efficiency in managing large vessel occlusions.
Background:
Most conventional 0.088 inch guide catheters cannot safely navigate intracranial vasculature. The objective of this study is to evaluate the safety of stroke thrombectomy using a novel 0.088 inch guide catheter designed for intracranial navigation.
Methods:
This is a multicenter retrospective study, which included patients over 18 years old who underwent thrombectomy for anterior circulation large vessel occlusions. Technical outcomes for patients treated using the TracStar Large Distal Platform (TracStar LDP) or earlier generation TRX LDP were compared with a matched cohort of patients treated with other commonly used guide catheters. The primary outcome measure was device-related complications. Secondary outcome measures included guide catheter failure and time between groin puncture and clot engagement.
Results:
Each study arm included 45 patients. The TracStar group was non-inferior to the control group with regard to device-related complications (6.8% vs 8.9%), and the average time to clot engagement was 8.89 min shorter (14.29 vs 23.18 min; p=0.0017). There were no statistically significant differences with regard to other technical outcomes, including time to recanalization (modified Thrombolysis In Cerebral Infarction (mTICI) ≥2B). The TracStar was successfully advanced into the intracranial internal carotid artery in 33 cases (73.33%); in three cases (6.67%), it was swapped for an alternate catheter. Successful reperfusion (mTICI 2B-3) was achieved in 95.56% of cases. Ninety-day follow-up data were available for 86.67% of patients, among whom 46.15% had an modified Rankin Score of 0-2%, and 10.26% were deceased.
Conclusions:
Tracstar LDP is safe for use during stroke thrombectomy and was associated with decreased time to clot engagement. Intracranial access was regularly achieved.
