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Updated: Feb 11, 2026

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Thrombus Visualization Using Low-Pressure Contrast Injection via a Small-Bore Aspiration Catheter in M2 Thrombectomy:

Takaaki Amamoto1, Koichiro Takemoto2, Yuta Oka1

  • 1Department of Neurosurgery, Kawano Neurological Hospital, Oita, Oita, Japan.

Journal of Neuroendovascular Therapy
|February 10, 2026
PubMed
Abstract

Insights

A new technique visualizes brain clots in middle cerebral artery (M2) occlusions using the aspiration catheter itself. This safe method aids mechanical thrombectomy by clearly outlining the thrombus, improving reperfusion success.

Area of Science:

  • Neurology
  • Interventional Neuroradiology
  • Medical Devices

Background:

  • Accurate thrombus localization in M2 segment occlusions is crucial for successful mechanical thrombectomy.
  • Conventional methods using microcatheter contrast injections carry risks.

Purpose of the Study:

  • To introduce and evaluate a novel visualization technique for thrombus delineation in M2 occlusions.
  • To minimize risks associated with traditional contrast injection methods.

Main Methods:

  • Aspiration catheter system used for direct thrombus visualization.
  • Low-pressure contrast injection through the intermediate catheter after microcatheter/guidewire withdrawal.
  • Observation of a meniscus sign indicating catheter-thrombus contact.

Main Results:

  • Successful visualization of the thrombus proximal surface as a meniscus sign.
  • Complete reperfusion (TICI grade 3) achieved in 2 aspiration passes.
  • No procedural complications observed during aspiration thrombectomy.

Conclusions:

  • The novel technique provides a simple, safe, and effective method for direct thrombus visualization in M2 occlusions.
  • Utilizing the intermediate catheter for controlled injection reduces distal embolization risk and simplifies workflow.
  • Preliminary evidence suggests potential for enhanced first-pass recanalization success, warranting further investigation.
Keywords:
acute ischemic strokemechanical thrombectomymedium vessel occlusionmiddle cerebral arterysmall-bore aspiration catheter

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