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Published on: December 19, 2025
Microcatheter Aspiration Thrombectomy with a 0.025″ Microcatheter for Distal Vessel Occlusions in Acute Ischemic
Mohammad Almohammad1,2, Lisa Hekers3, Mete Dadak4
1Department of Neuroradiology, Marburg University, Marburg, Germany. mohammad.almohammad1988@outlook.com.
Objectives:
To evaluate the feasibility and safety of microcatheter aspiration thrombectomy (MAT) using a 0.025″ microcatheter (PX-SLIM™) for distal vessel occlusions (DVOs) in acute ischemic stroke (AIS) with disabling deficits, and to explore outcome differences between patients with and without intravenous thrombolysis (IVT).
Methods:
This retrospective multicenter study included 21 highly selected AIS patients (July 2022-June 2024) with angiographically confirmed DVOs in the M3-M4, A3-A4, or P3-P4 segments. All had an Alberta Stroke Program Early CT Score (ASPECTS) of 10 and disabling deficits and underwent MAT using the PX-SLIM™ microcatheter. Outcomes included clinical scores-National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS)-angiographic reperfusion using the modified Thrombolysis in Cerebral Infarction (mTICI; success ≥ 2b), and procedural safety.
Results:
14 patients (66.7%) received IVT + MAT and 7 (33.3%) MAT alone. Successful reperfusion (mTICI ≥ 2b) was achieved in all 21 patients (100%). Median NIHSS improved from 3 at admission to 1 at discharge and 0 at 3 months. At discharge, 90.5% had an mRS of 1 and 9.5% an mRS of 2; at 3 months, 85.7% achieved mRS 0 and 14.3% mRS 1. No hemorrhage, dissection, distal embolization, or AIS recurrence occurred; transient vasospasm was observed in 38% without clinical impact.
Conclusion:
MAT using the PX-SLIM™ microcatheter appears to be a technically feasible approach with an acceptable safety profile in this small, highly selected cohort. The encouraging results are exploratory, and larger prospective studies are needed to confirm these findings.
Insights
Microcatheter aspiration thrombectomy (MAT) using the PX-SLIM™ device is a safe and feasible treatment for acute ischemic stroke (AIS) distal vessel occlusions (DVOs). This minimally invasive procedure showed high reperfusion rates and excellent patient outcomes.
Area of Science:
- Neurology
- Interventional Neuroradiology
- Vascular Neurology
Background:
- Distal vessel occlusions (DVOs) in acute ischemic stroke (AIS) present unique treatment challenges.
- Microcatheter aspiration thrombectomy (MAT) offers a minimally invasive approach for DVOs.
- Evaluating novel microcatheter technologies is crucial for improving stroke treatment outcomes.
Purpose of the Study:
- To assess the feasibility and safety of using a 0.025″ microcatheter (PX-SLIM™) for MAT in patients with AIS and DVOs.
- To evaluate clinical and angiographic outcomes following MAT for DVOs.
- To compare outcomes between patients receiving MAT with and without intravenous thrombolysis (IVT).
Main Methods:
- Retrospective multicenter study of 21 highly selected AIS patients with DVOs (M3-M4, A3-A4, P3-P4 segments).
- All patients had an Alberta Stroke Program Early CT Score (ASPECTS) of 10 and disabling deficits.
- MAT was performed using the PX-SLIM™ 0.025″ microcatheter; outcomes assessed via NIHSS, mRS, and mTICI scores.
Main Results:
- Successful reperfusion (mTICI ≥ 2b) was achieved in 100% of patients.
- Significant improvement in National Institutes of Health Stroke Scale (NIHSS) scores from admission to 3 months.
- High rates of functional independence at discharge (90.5% mRS ≤ 1) and 3 months (85.7% mRS 0).
- No procedural complications such as hemorrhage, dissection, or distal embolization were reported.
Conclusions:
- MAT with the PX-SLIM™ 0.025″ microcatheter is technically feasible and safe for treating DVOs in selected AIS patients.
- The procedure demonstrates high rates of successful reperfusion and favorable functional outcomes.
- Larger prospective studies are warranted to validate these preliminary findings in a broader patient population.
