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Super-large bore catheter in the treatment of large vessel occlusions: initial multicenter experience
Edgar A Samaniego1, Andres Gudino2, Leonardo Cruz-Criollo2
1Department of Neurology, Neurosurgery and Radiology, University of Iowa, Iowa City, Iowa, USA edgarsama@gmail.com.
Insights
The Cereglide 0.092" catheter shows promise for mechanical thrombectomy (MT) in large vessel occlusions (LVOs), achieving a 50% first pass effect and 88% successful reperfusion with a safe profile.
Area of Science:
- Endovascular therapy
- Neurointerventional procedures
- Cerebrovascular disease management
Background:
- Large bore catheters are increasingly utilized in mechanical thrombectomy (MT) for large vessel occlusions (LVOs).
- The super-large bore Cereglide 0.092" (C-92) catheter offers the largest available inner diameter for advanced endovascular interventions.
Purpose of the Study:
- To evaluate the efficacy and safety of the Cereglide 0.092" (C-92) catheter in MT for LVOs.
- Assess key performance indicators including first pass effect (FPE) and successful reperfusion rates.
Main Methods:
- A multicenter observational study involving 12 US stroke centers.
- Efficacy outcomes: first pass effect (mTICI ≥2c on first pass) and successful reperfusion (final mTICI ≥2c).
- Safety outcomes: device-related complications, symptomatic intracranial hemorrhage (sICH), and mortality; functional outcomes: mRS and NIHSS scores.
Main Results:
- The C-92 catheter successfully reached the thrombus in 82% of 50 patients, with a median puncture-to-thrombus time of 15 minutes.
- Achieved a 50% first pass effect (FPE) and 88% successful reperfusion.
- Reported no vessel perforations or sICH, with 8% distal embolization and 8% mortality; median mRS at discharge was 3.
Conclusions:
- The C-92 catheter demonstrates a safe profile for MT in LVOs.
- Achieved a 50% overall FPE and favorable functional outcomes in 88% of treated patients.
- Supports the use of super-large bore catheters for improved endovascular treatment efficiency.
Purpose:
Large bore catheters are increasingly used in mechanical thrombectomy (MT) for large vessel occlusions (LVOs).
Objective:
To evaluate the efficacy and safety of the super-large bore Cereglide 0.092" (C-92) catheter, featuring the largest inner diameter available.
Methods:
A multicenter observational study was conducted across 12 comprehensive stroke centers in the United States. Efficacy outcomes included the first pass effect (FPE) and successful reperfusion. FPE was defined as a first MT pass achieving a modified Treatment in Cerebral Infarction (mTICI) score of ≥2c. Successful reperfusion was defined as final mTICI score ≥2c. Safety outcomes involved device-related complications, symptomatic intracranial hemorrhage (sICH), and inpatient mortality. Functional outcomes included modified Rankin Scale (mRS) score at discharge and delta National Institutes of Health Stroke Scale (NIHSS) score.
Results:
Fifty patients were included. The most common LVO was the first segment of the middle cerebral artery in 31/50 cases (62%). The C-92 reached the thrombus in 41 patients (82%). Median puncture-to-thrombus and puncture-to-reperfusion times were 15 min (IQR 10-25) and 26 min (IQR 15-49), respectively. FPE was achieved in 25/50 (50%) cases, and in 25/41 (61%) cases when the C-92 reached the thrombus. Successful reperfusion occurred in 36/41 patients (88%). There were no vessel perforations, or sICH. Distal embolization occurred in 4/50 (8%) cases, and 4/50 (8%) died. The mRS score at discharge was 3 (IQR 2-6), and the delta NIHSS score was 8 (IQR 5-12).
Conclusion:
The C-92 catheter demonstrated a safe profile achieving an overall FPE rate of 50%, and favorable functional outcomes in 88% of cases.
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