Medium vessel occlusion thrombectomy: Single center experience using the 3 MAX catheter

Area of Science:

• Neurology
• Interventional Neurology
• Medical Devices

Background:

• Medium vessel occlusion (MeVO) stroke presents a significant clinical challenge.
• Mechanical thrombectomy is a key treatment for acute ischemic stroke.
• The Penumbra 3MAX aspiration catheter's utility in MeVO requires further investigation.

Purpose of the Study:

• To evaluate the efficacy and safety of the Penumbra 3MAX aspiration catheter in mechanical thrombectomy for MeVO.
• To compare the performance of the 3MAX catheter when used as a de novo (first-pass) device versus a rescue device.

Main Methods:

• Retrospective review of 84 patients undergoing mechanical thrombectomy with the 3MAX catheter at a comprehensive stroke center (January 2017 - January 2023).
• Primary efficacy endpoint: successful recanalization (TICI grade ≥ 2c).
• Primary safety endpoint: incidence of intracerebral hemorrhage.

Main Results:

• The 3MAX catheter was used as a de novo device in 32.1% and as a rescue device in 67.9% of cases.
• Successful recanalization (TICI ≥ 2c) was achieved in 41.6% of all patients.
• Recanalization rates were comparable between de novo (68.18%) and rescue (72.22%) use (p=0.67).
• Hemorrhagic complications occurred in 9.5% of patients.

Conclusions:

• The Penumbra 3MAX aspiration catheter is a safe and effective option for mechanical thrombectomy in MeVO.
• Its performance is consistent whether utilized as an initial or a subsequent (rescue) device.
• The study highlights similar successful recanalization rates and low hemorrhagic risk for both application strategies.