Macrowire-only direct aspiration first-pass technique for endovascular mechanical thrombectomy: Multicenter technical...

Area of Science:

• Neurology
• Interventional Neuroradiology
• Medical Devices

Background:

• Large-bore aspiration catheters (ACs) are crucial for mechanical thrombectomy in acute ischemic stroke.
• Microcatheter-free delivery of ACs can streamline endovascular procedures.
• Macrowires may offer a solution for facilitating AC navigation in complex neurovasculature.

Purpose of the Study:

• To evaluate the safety and efficacy of the Aristotle Colossus Guidewire for microcatheter-free delivery of large-bore ACs.
• To assess the performance of this macrowire in anterior circulation endovascular mechanical thrombectomy.
• To identify factors influencing successful AC delivery using the guidewire.

Main Methods:

• Retrospective analysis of prospective data from 12 institutions.
• Inclusion of patients undergoing anterior circulation mechanical thrombectomy with the Aristotle Colossus Guidewire.
• Assessment of primary endpoint: successful AC delivery without adjunct devices; secondary endpoint: successful reperfusion.

Main Results:

• Successful microcatheter-free AC delivery was achieved in 87.7% of 122 patients.
• 76.2% of patients achieved successful reperfusion (TICI grade ≥ 2B) without a microcatheter.
• Severe carotid artery tortuosity and intracranial atherosclerotic disease were associated with lower success rates.

Conclusions:

• The Aristotle Colossus Guidewire demonstrates favorable performance in anterior circulation ischemic stroke intervention.
• This macrowire facilitates safe navigation of large-bore ACs without requiring a microcatheter or stentriever.
• The findings support the use of this macrowire to improve efficiency in mechanical thrombectomy procedures.