SOFIA Nonwire Advancement techniKE 35 Technique: A Minimalist Approach to Stroke Thrombectomy

Area of Science:

• Interventional Neurology
• Vascular Neurology
• Medical Devices

Background:

• The Soft Torqueable Catheter Optimized for Intracranial Access (SOFIA) facilitates intracranial access.
• The SOFIA Nonwire Advancement techniKE (SNAKE) allows advancement without a microcatheter.
• SNAKE35 is a novel variation using a 0.035-inch guidewire for biaxial navigation.

Purpose of the Study:

• To evaluate the performance of the SNAKE35 technique.
• To assess its efficacy in acute stroke thrombectomy procedures.

Main Methods:

• Retrospective analysis of 140 acute stroke thrombectomy patients (Jan 2017-Feb 2019).
• Comparison between SNAKE35 (n=79) and conventional navigation (n=61) groups.
• Primary endpoint: successful catheter positioning at occlusion site using SNAKE35.

Main Results:

• SNAKE35 achieved successful catheter positioning in 84% of cases (66/79).
• Reduced groin puncture to revascularization time (26 min vs. 37 min, P < .05).
• Higher success rate in SNAKE35 group despite older patients and increased sedation.

Conclusions:

• SNAKE35 is an effective and safe technique for SOFIA navigation.
• It enables rapid intracranial access to the anterior circulation occlusion site.
• The technique leads to a significant decrease in procedural times.