P60 SLIC (Super Large-bore Ingestion Clot) technique: acute ischemic stroke large vessel occlusion treatment with super large bore aspiration and novel insert catheters. (29th August 2022)

• Record Type: Journal Article
• Authors: Massari, F; Dabus, G; Cortez, G; Singh, J; Kuhn, AL; Naragum, V; Anagnostakou, V; Hanel, R; Gounis, M; Puri, A
• Is Part Of: Journal of neurointerventional surgery. Volume 14(2022)Supplement 2
• Page Start: A32
• Page End: A32
• Publication Date: 2022-08-29
• Subjects: Nervous system -- Surgery -- Periodicals; Cerebrovascular disease -- Surgery -- Periodicals; 617.48
• DOI: 10.1136/neurintsurg-2022-ESMINT.81
• Languages: English
• ISSNs: 1759-8478

Abstract

Abstract : Introduction: Super large bore aspiration (SLBA) has shown high rates of complete ingestion. Herein, we report the initial clinical feasibility, safety and efficacy of this novel "SLIC" (Super Large-bore Ingestion Clot) technique for stroke. Methods: We performed a retrospective review of three centers neurointerventional databases. SLIC entails a triaxial assembly: an 8 Fr 0.106" guide catheter, an 0.088" 62cm catheter extender and a Tenzing 8 insert catheter that completely consumes the inner diameter of the catheter extender SLBA catheter.The Tenzing 8 navigates to the proximal aspect of the occlusion.The 0.088" catheter extender is delivered over the Tenzing 8, which is withdrawn thereby exerting an aspiration force, applied through the Base Camp catheter and 0.088" catheter extender as a single assembly. Results: Between February 2021 and January 2022, 33 consecutive patients of LVO were treated with SLBA. The median age of was 70 years (30–91) and 17 were male (51%). The median presenting NIHSS and ASPECTS score was 21 (1–34) and 8 (5–10), respectively. Delivery of the large bore 0.088 catheter to the site of the occlusion was achieved in all cases.The successful revascularization rate (mTICI≥2B) was 100%, with single pass efficacy in most of the cases (82%). Final mTICI was 3 in 73.5%, 2C in 20.6%, and 2B in 5.9%. There were no adverse events or post-procedural symptomatic hemorrhages. Conclusions: Our initial experience with SLBA resulted in 100% mTICI≥2B with 82% first pass success. Navigation of the large-bore catheter extender over the Tenzing insert was successful and safe in this early experience. References: Frölich AM, Kim W, Stribrny K, et al . The novel tenzing 7 delivery catheter designed to deliver intermediate catheters to the face of embolus without crossing: clinical performance predicted in anatomically challenging model. J Neurointerv Surg 2021 Aug;13 (8):722–726. Do you have any conflict of interest to declare? : No