Endovascular Stroke Therapy Focused on Direct Clot Aspiration Using the SOFIA^TM Catheter for Acute Ischemic Stroke

To report our experience of mechanical thrombectomy using the SOFIA < sup > TM < /sup > catheter, in terms of its effectivenessicacy and safety.

Acute ischemic stroke patients with large vessel occlusions who underwent mechanical thrombectomy, with the SOFIA < sup > TM < /sup > aspiration catheter as the first-line approach, were retrospectively identified. For all patients, the data, including reperfusion success (modified Thrombolysis in Cerebral Infarction [mTICI]), procedural details, clinical status at the baseline and post-discharge at 90 days, and complications, were analysed.

During the study period (January 2017-July 2020), 73 patients underwent endovascular thrombectomy. The mean age and the baseline National Institutes of Health Stroke scores were 72 (41-83) and 16 (12-25), respectively. Successful reperfusion (mTICI≥2b-3) was obtained in 80.8 % (n=59) of the patients. Using ADAPT, a first-pass effect was achieved in 63.01% (n=46) of the patients. Rescue stent retriever (SRV) had to be utilized in 36.98% (n=27) of the patients; all presented with a favourable clinical outcome (modified Rankin score ≤0-2) at 90 days. The complication rate in the study was 13.7% (n=10).

The contact aspiration approach with SOFIA < sup > TM < /sup > catheters as a first-line device appears to be fast, safe, and effective. Our results were comparable to the findings of other series. In the case of insufficient response on contact aspiration, we could easily modify the SOFIA < sup > TM < /sup > catheter approach for an additional stent retriever rescue treatment.