CEREGLIDE 71 catheter for contact aspiration of secondary distal medium vessel occlusion: A case report

Mechanical thrombectomy for large vessel occlusion (LVO) in acute ischemic stroke may result in distal medium vessel occlusion (DMVO) during the procedure. Large-bore catheters are commonly selected for LVO treatment, but their use for DMVO is desirable from the perspective of simplifying the procedure and reducing procedure time. Here, we report a case of primary LVO with secondary DMVO successfully treated using a large-bore aspiration catheter (CEREGLIDE 71, 132 cm). To our knowledge, there are no previous reports describing the use of CEREGLIDE 71 not only for LVO but also for secondary DMVO treatment. A 74-year-old man with a history of atrial fibrillation was transported to our hospital by ambulance. Magnetic resonance imaging revealed acute cerebral infarcts, and magnetic resonance angiography demonstrated occlusion of the left internal carotid artery. Intravenous thrombolysis and mechanical thrombectomy were performed. A combined technique using CEREGLIDE 71 and a stent retriever achieved recanalization of the primary LVO but resulted in secondary DMVO (distal middle cerebral artery M2 occlusion). Under a modified working angle, the CEREGLIDE 71 used for LVO treatment was carefully advanced to the distal occlusion site. Contact aspiration with CEREGLIDE 71 achieved successful recanalization without complications. At 10 months after the procedure, there was no evidence of vascular injury. CEREGLIDE 71 is a large-bore aspiration catheter with high accessibility, allowing seamless transition to secondary DMVO treatment without device exchange. Careful device manipulation and detailed anatomical assessment of the vascular architecture leading to the occlusion site are required.