The Q and A-The MIVI Q Catheters for Aspiration Thrombectomy-Initial Experience from London

Aspiration thrombectomy is a widely accepted treatment option for large vessel occlusion (LVO). The MIVI aspiration system has a novel design to maximize the lumen size. We present the results of our initial experience with this innovative aspiration thrombectomy system.

Retrospectively, we reviewed our database to find all cases of LVO treated with the MIVI Q system (February 2019 and July 2020). In addition, we recorded the baseline demographics, NIHSS, ASPECT, mTICI scores, procedural time, complications, and 90 day mRS.

Herein, we identified 25 patients with an average age of 65.3 ± 19.3 years (range 19-89), majority of whom were female (n = 14, 56%). The average NIHSS was 16.9 ± 6.7 (range 6-30), and the average CT ASPECT was 7.9 ± 1.4 (range 5-10). The most common clot location was the M1 segment of the MCA (n = 16, 64%). Four of the patients had tandem lesions (16%). The average clot length was 21.7 ± 31 mm (range 2-130 mm). Of the 23 cases where the Q catheter reached the proximal clot face, mTICI ≥ 2b was achieved on the first pass in 11 cases (44%), and at the end of the 'Q aspiration' only the procedures with 16 patients achieved mTICI ≥ 2b recanalization (64%). Stent-retrievers were used in 13 cases (52%). At the end of the procedure, 24 patients (96%) achieved mTICI ≥ 2b with 18 patients (72%) achieving mTICI ≥ 2c. The average number of passes with the Q catheter, including when it was used for SOLUMBRA, was 2.1 ± 2.2 (range 1-10). The mean procedure time was 69 ± 32 mins (range 7-116 mins). No complications were associated with the MIVI Q.

The MIVI aspiration system is a novel technology with regards to aspiration mechanical thrombectomy. The system is easy to use with early results comparable to other large-bore catheter systems. However, further studies are needed.