Distal vessel aspiration (DIVA) with the RED 043 catheter in acute ischaemic stroke

Acute ischaemic stroke (AIS) due to medium vessel occlusion (MeVO) is increasingly recognised as the next frontier for endovascular mechanical thrombectomy (EMT).^1,2 A recognized method of recanalisation of MeVOs is the blind exchange/mini-pinning (BEMP), employing a stent retriever and a low profile aspiration catheter, such as the Penumbra 3MAX Reperfusion Catheter.³ One potential disadvantage of this technique is the necesssity of stent retriever (SR), which may increase procedural risks, considering the smaller calibre and tortuous arteries.^4,5 In addition, this may carry increased costs. This technical video highlights the "DIVA" technique: RED 043 aspiration catheter navigate to the target occlusion over he Aristotle 24 200 cm microwave, without the use of a microcatheter or SR, as far as A4, M4 and P4 segments.