First in-human use of super large-bore novel 0.092-inch catheter positioned in M1 segment of middle cerebral artery for aspiration thrombectomy.

Abstract

An octogenarian patient with a medical history of hypertension and prior stroke (baseline modified Rankin Scale score of 1) presented with acute onset left-sided hemiplegia and neglect and was found to have a right middle cerebral artery M1 occlusion, likely from an embolic clot as there was no hint of intracranial atherosclerosis or dissection in the CT scan. He underwent emergent EVT using direct aspiration technique via a novel super large-bore 0.092-inch ID catheter, which was positioned in the M1 segment. This is the first clinical report of using a 0.092-inch ID catheter in the M1 segment, which resulted in full recanalisation (thrombolysis in cerebral infarction score 3 (TICI3)) of the artery without any adverse events. The patient had significant early clinical improvement, and a follow-up imaging revealed a relatively small infarct size and no haemorrhagic complications. Utilisation of super large-bore 0.092-inch ID catheter for direct aspiration in proximal large vessel occlusion might further optimise the efficacy of the aspiration pass by increasing the aspiration force and inducing local flow arrest.