E-097 Technical outcomes of mechanical thrombectomy using the sofia plus aspiration catheter

2020 
Introduction The Sofia Plus aspiration catheter (Microvention; Tustin, CA) is a recently introduced 0.070-inch inner diameter catheter designed to provide distal intracranial access and engage thrombus to facilitate thrombectomy for acute ischemic stroke. Methods This single-center retrospective study assessed technical outcomes of mechanical thrombectomy using the Sofia Plus aspiration catheter. Utilizing a prospective database of all acute stroke interventions at our institution, cases utilizing SOFIA Plus on the first pass were identified. Patient characteristics, procedural details, and radiographic outcomes were analyzed. Results Sofia Plus was utilized as a first pass aspiration catheter in 138 cases. Patients presented with a median NIHSS of 17 (IQR 10–22), ASPECT of 10 (IQR 8–10), and had target occlusions involving the ICA (n=30), M1 (n=73), M2 (n=22), or basilar artery (n=13). The aspiration catheter was used for first-pass direct aspiration alone in 86 patients (62%), and in conjunction with a stent retriever in 52 patients (38%). A recanalization grade of TICI 2b or better was achieved in 118 patients (86%), which was accomplished with a single pass in 88 (64%). Median time from groin puncture to recanalization was 44 minutes (IQR 30–68). Comparison of direct aspiration alone versus with stent retrievers demonstrated no difference in recanalization grade (p=0.64) or rates of first-pass recanalization (p=0.28), but direct aspiration was associated with faster recanalization (41 vs 53 minutes, p=0.02). There were two cases of vessel perforation (both involving stent retrievers), and two additional patients had symptomatic ICH on follow-up CT. Conclusions Our experience demonstrates that the SOFIA Plus aspiration can facilitate safe and effective revascularization for acute ischemic stroke, either using a direct aspiration technique or in conjunction with a stent-retriever. However, reperfusion was achieved faster with direct aspiration alone. Disclosures A. Witek: None. T. Patterson: None. L. Sheikhi: None. M. Bain: 2; C; Medtronic PLC, Stryker Corp. M. Hussain: 2; C; Johnson & Johnson. G. Toth: None.
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