Steam Shaping of Angled-Tip Aspiration Catheter to Improve Deliverability in Treating Acute Ischemic Stroke

Innovations in the treatment of large vessel occlusion strokes include maximizing the speed and success in clot retrieval, but there is limited exploration of steam shaping to angled-tip aspiration catheters. The objective of our study was to assess the outcomes and efficacy of steam-shaped angled-tip aspiration catheters in conjunction with a nonwire advancement technique.

Our case series included patients with anterior circulation large vessel occlusion using a nonwire advancement technique with a steam-shaped angled-tip aspiration catheter (Zoom 71^TM Imperative Care, Inc.). Outcomes were aspiration passes, time to first pass and recanalization, degree of final reperfusion (thrombolysis in cerebral infarction), and adverse outcomes.

Of the 10 cases analyzed, 60% were men, with a median age of 70 (IQR 62.3-75.5) and a median National Institutes of Health Stroke Scale score of 22.5 (IQR 19.3-25.0). Overall, 70% had singular occlusions, whereas tandem occlusions included 1 internal carotid artery (ICA)-M1 and 2 ICA-M2 cases. Most (60%) had a cavernous carotid siphon angle type II. First pass took 11.5 minutes (IQR 10.0-15.0), and recanalization took 20.0 minutes (IQR 15.8-25.8) with an average of 2.2 passes. For singular occlusions, 57.1% of cases required 2 or fewer passes. The tandem ICA-M1 occlusion needed only one pass at each location, whereas both ICA-M2 occlusions required 1 ICA pass with Zoom^TM 71 with a pass at M2 with Zoom^TM 45. Overall, 80% of cases achieved a final thrombolysis in cerebral infarction score of 2C or greater. There were no intraoperative complications, although 4 cases presented with postoperative complications and 1 death unrelated to the procedure. In all cases, the aspiration catheter was able to be delivered without the use of another device.

Steam shaping of angled-tip catheters seems to perform superiorly when utilizing a nonwire advancement technique without compromising patient safety.