An in vitro assessment of aspiration technologies: Location of conduit for 6F aspiration catheters and design of catheter tip influence clot retrieval success.

Background8F catheters serve as conduits to provide stable access and support for delivery of 6F aspiration catheters (ACs) in Acute Ischaemic Stroke treatment. Superbore catheters (SBCs) (internal diameter (ID) > 0.088″) are the latest innovation, designed for placement in the middle cerebral artery (MCA). SBCs may improve recanalization via enhanced control of blood pressure and flow, in comparison to balloon guide catheter (BGC) and regular guide catheter (GC) systems.AimTo objectively assess conduit catheter technologies in terms of deliverability, local impact on blood pressure and flow, and clot retrieval success in vitro.MethodsTwo in vitro models were used. Two SBCs, (CEREGLIDE92 and TracStar/Zoom88) and one BGC (EMBOGUARD) were used with 0.071″ ACs, and one GC (NeuronMAX) was evaluated with two 6F ACs (RED68 and SOFIA). M1-MCA occlusions were created with cohesive and friable thrombus analogues. Device tracking and clot retrieval were evaluated by two neurointerventionalists, under physiological haemodynamic conditions.ResultsSBC positioning in the MCA resulted in significant reductions of local blood pressure and flow in comparison to GC systems positioned in the Internal Carotid Artery (p = .000). However, when the SBC could not reach the MCA, they displayed similar haemodynamic control as the GC systems. SBC systems achieved high retrieval success for friable thrombi, likely due to flow reversal in the MCA during aspiration (p = .000). The TracStar/Zoom SBC system had lower rates of cohesive retrieval success due to difficulties in catheter tracking and poor clot alignment with the catheter bevelled tip.ConclusionClot retrieval success is influenced by the location of the conduit for the 6F AC and the design of the AC tip.