Interventional Neuroradiology最新文献

{"title":"Selective brain cooling with a novel catheter reduces infarct growth after recanalization in a canine large vessel occlusion model.","authors":"Robert M King, Vania Anagnostakou, Mohammed Salman Shazeeb, Shannon Hornibrook, Jennifer Mitchell, Mark Epshtein, Christopher Raskett, Nils Henninger, Ajit S Puri, Thomas L Merrill, Matthew J Gounis","doi":"10.1177/15910199241266010","DOIUrl":"10.1177/15910199241266010","url":null,"abstract":"<p><p>BackgroundTherapeutic hypothermia has shown potential in cardiac intervention for years; however, its adoption into the neurovascular space has been limited. Studies have pointed to slow cooling and limited depth of hypothermia yielding negative outcomes. Here we present an insulated catheter that allows for consistent infusion of chilled saline directly to the brain. Direct delivery of cold saline allows a faster depth of hypothermia, which could have a benefit to the growth of ischemic lesions.MethodsTen canines were randomized to either receive selective brain cooling or no additional therapy. Eight animals were successfully enrolled (n = 4 per group). Each animal underwent a temporary middle cerebral artery occlusion (MCAO) for a total of 45 min. Five minutes prior to flow restoration, chilled saline was injected through the ipsilateral internal carotid artery using an insulated catheter to ensure delivery temperature. The treatment continued for 20 min, after which the animal was transferred to an MRI scanner for imaging.ResultsOf the 8 animals that were successfully enrolled in the study, 3 were able to survive to the 30-day endpoint with no differences between the cooled and control animals. There was no difference in the initial mean infarct size between the groups; however, animals that did not receive cooling had infarcts continuing to progress more rapidly after the MCAO was removed (13.8% vs 161.3%, p = 0.016, cooled vs control).ConclusionsSelective hypothermia was able to reduce the post-MCAO infarct progression in a canine model of temporary MCAO.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"2116-2123"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141751709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Vecta 46 intermediate catheter for mechanical thrombectomy of distal medium vessel occlusions: A single-center experience.","authors":"Joo Won Choi, Yang Qiao, Tej I Mehta, Thomas M Clausen, Y Jonathan Zhang, Samuel Tsappidi, Ferdinand K Hui","doi":"10.1177/15910199241283513","DOIUrl":"10.1177/15910199241283513","url":null,"abstract":"<p><p>IntroductionWith emerging evidence supporting the clinical efficacy and safety of mechanical thrombectomy (MT) for distal medium vessel occlusions (DMVOs), MT devices specifically designed to navigate through smaller caliber and more delicate tortuous distal cerebrovasculature are required. This study describes our single-center experience using the AXS Vecta 46 intermediate catheter for first-line thromboaspiration of DMVOs.MethodsWe identified all patients who underwent MT using the Vecta 46 for first-line thromboaspiration for primary or secondary DMVOs. We collected baseline clinical data, angiographic and clinical outcomes, as well as procedural complications. The primary outcome in question was the rate of successful recanalization, which was defined as a modified Thrombolysis in Cerebral Infarction score of ≥2b.ResultsWe identified 43 patients who underwent MT using the Vecta 46 catheter for thromboaspiration of 54 DMVOs. Intervened vessels included the M2 (23/54), M3 (19/54), and M4 (6/54) branches of the middle cerebral artery, A2 (1/54), A3 (1/54), and A4 (1/54) branches of the anterior cerebral artery, and P1 (1/54), P2 (1/54), and P4 (1/54) branches of the posterior cerebral artery. The median number of passes for primary DMVOs was 2 (IQR: 1-3) and 1 (IQR: 1-1.25) for secondary DMVOs. The rate of successful recanalization was 100% (18/18) for primary DMVOs and 80.6% (29/36) for secondary DMVOs. First-pass effect (FPE) was noted in 55.6% (30/54) of all primary and secondary DMVO cases. Improved short-term clinical outcomes were observed in both the primary (National Institute of Health Stroke Scale [NIHSS] shift: -5 [IQR: -14.25 to -0.25]) and secondary (NIHSS shift: -5 [IQR: -10 to -2]) DMVO groups. A total of six patients died during their hospitalization, though none were deemed procedural-related.ConclusionsOur study demonstrates the safety and efficacy of the Vecta 46 intermediate catheter for thromboaspiration of both primary and secondary DMVOs, achieving high rates of successful recanalization and FPE.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"2470-2475"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Soft partial release of non-aggressive stent retriever technique for very distal arterial occlusion stroke.","authors":"Peter B Sporns, Mohammad Almohammad, Zoltan Puskas, Hassan Soda, Thi Dan Linh Nguyen-Kim, Ole Simon, Lars Timmermann, André Kemmling","doi":"10.1177/15910199241299471","DOIUrl":"10.1177/15910199241299471","url":null,"abstract":"<p><p>BackgroundEndovascular thrombectomy (EVT) for very distal vessel occlusion (DVO) stroke is increasingly performed but there is insufficient evidence on the efficacy and safety of distal EVT techniques. We hypothesized that the technique of soft partial release of non-aggressive stent retrievers (SPORNS) reduces friction on the perforating vessels during thrombectomy and thereby reduces bleeding complications.MethodsRetrospective study including consecutive DVO patients who were treated with the SPORNS technique between 1 January 2022 and 31 December 2022 at two tertiary stroke centers. DVOs were defined as isolated occlusions of the M3 and M4 segments of the middle cerebral artery, occlusions of the A2 and A3 segments of the anterior cerebral artery, and occlusions of the P2 and P3 segments of the posterior cerebral artery or of the superior cerebellar artery. The technique is described in detail and procedural and clinical outcomes are given.ResultsTwenty-four patients were treated with the SPORNS technique of whom 22 (92%) had complete or near complete recanalization (eTICI 2c/3). National Institutes of Health Stroke Scale (NIHSS) decreased from a median of nine (IQR 7-13) at admission to three (1-5) at discharge and 18 patients (75%) achieved a good outcome (modified Rankin scale 0-2) at day 90 post-stroke. Two patients (8%) had a small subarachnoid hemorrhage and two patients (8%) had a symptomatic intracerebral hemorrhage on follow-up imaging.ConclusionFor the treatment of very distal arterial occlusions, the SPORNS technique employing a soft partial release of a non-aggressive stent retriever is safe and effective for the thrombectomy of small clots. The technique potentially yields a lower rate of subarachnoid hemorrhages while achieving an excellent rate of complete and first-pass recanalization.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"2544-2549"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Control-matched octo/nonagenarian outcomes in acute basilar artery occlusions treated with mechanical thrombectomy-analysis of the PC-SEARCH thrombectomy registry.","authors":"Adam T Mierzwa, Paige Prologo-Richardson, Sami Al Kasab, Ashley Nelson, Santiago Ortega Gutierrez, Juan Vivanco-Suarez, Mudassir Farooqui, Ashutosh P Jadhav, Shashvat Desai, Gabor Toth, Anas Alrohimi, Thanh N Nguyen, Piers Klein, Mohamad Abdalkader, Hisham Salahuddin, Zachary Wilseck, Aditya Pandey, Sravanthi Koduri, Nirav Vora, Nameer Aladamat, Khaled Gharaibeh, Ehad Afreen, Syed Zaidi, Mouhammad Jumaa","doi":"10.1177/15910199241265397","DOIUrl":"10.1177/15910199241265397","url":null,"abstract":"<p><p>IntroductionAge is often used as a predictor in determining outcomes in large vessel occlusions treated with mechanical thrombectomy. However, limited data exist for octo/nonagenarian outcomes compared to younger individuals in acute basilar artery occlusions treated with thrombectomy.MethodsPatient data were obtained from the PC-SEARCH Thrombectomy Registry which consists of 444 acute basilar artery occlusions treated with mechanical thrombectomy. Individuals were dichotomized based on age (>80 and ≤80 years old). Primary outcome was defined as modified Rankin Scale of 0-3 at 90 days. Logistic and multivariate regression, as well as control-matched analysis, were performed.ResultsThere were 373 and 71 patients in the younger and older cohorts, respectively. Gender, ethnicity, smoking status, atrial fibrillation, and coronary artery disease were noted to be significantly different between cohorts. At 90 days, 178 (47.7%) and 23 (32.4%) patients achieved primary outcome at 90 days (p = 0.02), however, after controlling for potentially confounding factors this association lost significance (OR 0.50 95% CI 0.24-1.05; p = 0.07). There were 84 patients included in the control matched analysis and demonstrated no significant differences on multivariate analysis between cohorts (OR 0.68 95% CI 0.25-1.84; p = 0.45).InterpretationOcta/nonagenarians presenting with an acute basilar artery occlusion treated with mechanical thrombectomy can achieve acceptable rates of favorable functional outcomes compared to younger individuals with similar baseline demographic and stroke characteristics.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"2129-2134"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141751708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An <i>in-vitro</i> method for comparative analysis of aspiration catheter tracking performance.","authors":"Fritz Wodarg, Patrick Brouwer, Sarah Power, Michael Gilvarry, Mahmood Mirza, Richard Conlon, Sarah Johnson, Ray McCarthy","doi":"10.1177/15910199241278993","DOIUrl":"10.1177/15910199241278993","url":null,"abstract":"<p><p>Background and purposeMechanical thrombectomy (MT) for acute ischemic stroke (AIS) relies on efficient tracking of aspiration catheters through complex vascular anatomies. Differences in catheter design lead to variation in tracking performance which may only become apparent after use in patients. We developed an <i>in-vitro</i> methodology for evaluating aspiration catheter performance under a variety of pre-defined circumstances, that can be used during catheter development for design optimization.MethodsValidation of the <i>in-vitro</i> methodology involved testing four large bore aspiration catheters on recreated challenging vascular access routes derived from patient angiograms. Two experienced neurointerventionalists conducted the tests under controlled physiological and procedural conditions. Each catheter design was evaluated across 30 unique anatomy-procedural set-up combinations. A fifth, prototype large bore catheter was evaluated by trained engineers to assess the applicability of the <i>in-vitro</i> test.ResultsResults from statistical analysis using a general linear model demonstrated the methodology's effectiveness in detecting significant tracking differences among catheter designs (<i>p</i> < 0.01). Minimal inter-operator variability was observed (<i>p</i> = 0.304), while procedural techniques significantly influenced tracking performance (<i>p</i> < 0.01). The tortuosity of the arterial access route notably impacted catheter performance (<i>p</i> < 0.01), with anatomical features revealing varying degrees of influence on desirable and undesirable catheter design aspects.ConclusionWe successfully developed a test methodology for evaluating the trackability of large bore aspiration catheters intended for treating acute ischemic stroke with large vessel occlusions. This methodology offers a robust approach to pre-clinical design assessment, utilizing anatomical models that simulate real-world vascular challenges to enhance catheter optimization.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"2270-2277"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability assessment of distal occlusion eTICI scoring.","authors":"Jaydevsinh N Dolia, Jonathan A Grossberg, Pedro N Martins, Mohamed A Tarek, Aqueel Pabaney, Alhamza R Al-Bayati, Raul G Nogueira, Diogo C Haussen","doi":"10.1177/15910199241262844","DOIUrl":"10.1177/15910199241262844","url":null,"abstract":"<p><p>BackgroundThe eThrombolysis in Cerebral Infarction (eTICI) score has been validated in proximal large artery occlusion (pLAOs). Despite the growing number of distal medium vessel occlusions (DMVOs) mechanical thrombectomies (MT) and the widespread utilization of the eTICI scoring system, its reliability and standardization for more distal occlusions have not been validated. We aim to evaluate the interrater reliability of eTICI scores in primary DMVOs.MethodsThis was a retrospective analysis of a prospectively maintained database for consecutive patients with pLAO and DMVO MT at a single comprehensive stroke center from 2015 to 2022. Two fellowship-trained neurointerventionalists blindly/independently assessed digital subtraction angiograms for final eTICI, followed by consensus reads for discrepancies.Results59 DMVO of 2248 thrombectomies [M3:29(50%)/M4:1(2%)/A1:3(5%)/A2:12(22%)/A3: 5(9%)/P1:7(12%)/P2:1(2%)] and 124 pLAOs of 308 thrombectomies [i-ICA:13(11%)/MCA-M1: 111(90%)] were included. The distribution of final eTICI scores was comparable between pLAO vs DMVOs (p = 0.82). The pLAO final eTICI score assessment between two readers demonstrated moderate reliability with a kappa0.77 (95%CI: 0.67-0.88), while the DMVO eTICI score assessment exhibited almost-perfect agreement with kappa 0.94 (95%CI: 0.90-0.99). The agreement between the consensus read and the original report in DMVOs was 0.86 (95% CI: 0.71-1.00) while for pLAO it was 0.83(95% CI: 0.76-0.90). The performance of eTICI was comparable amongst different DMVO territories as well as for distal vs. very distal occlusions.ConclusioneTICI score exhibited comparable performance for DMVO as compared to pLAO strokes. Further studies investigating DMVO eTICI grading and clinical outcomes are warranted.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"2124-2128"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of delivery technique on Woven EndoBridge deployment and detachment in an <i>in vitro</i> aneurysm model.","authors":"Muhammed Amir Essibayi, David J Altschul","doi":"10.1177/15910199241273984","DOIUrl":"10.1177/15910199241273984","url":null,"abstract":"<p><p>BackgroundThe Woven EndoBridge (WEB) device is increasingly used for treatment of wide-neck bifurcation aneurysms. With the newer 17 system, WEB deployment has been associated with a phenomenon known as incomplete or \"sticky\" detachment from the delivery wire, which may lead to imprecise placement. Optimal techniques for WEB manipulation and delivery to avoid this problem are poorly defined. This study aimed to evaluate standard WEB deployment techniques and determine the impact of delivery techniques and WEB stickiness on procedural success.MethodsAn <i>in vitro</i> study using identical silicone middle cerebral artery aneurysm models (<i>n</i> = 32) assessed WEB (6 × 2 mm) deployment through a VIA 17 microcatheter via three techniques that involved: \"loading,\" \"neutral,\" and \"tension\" on the pusher wire. Microcatheter position was placed in varied positions from the WEB device. Woven EndoBridge stickiness was graded during detachment attempts. Primary outcomes were detachment stickiness and attempt number, compared between techniques using Fisher's exact test.ResultsThe tension technique resulted in significantly fewer sticky detachments and detachment attempts compared to forward load or neutral techniques (p < 0.001). Sticky detachment was lower with tension (0% sticky) versus forward load (42% sticky, 8% very sticky) (p < 0.001). Forward load had a 50% rate of stickiness versus 0% with tension and neutral (p < 0.001). Forward load required multiple attempts in 100%, compared to 57% with neutral and 8% with tension (p < 0.001). Higher stickiness grades increased the need for multiple attempts (p < 0.001).ConclusionThe tension technique reduces incomplete WEB detachment and enables precise single-attempt detachment, optimizing delivery precision. <i>In vivo</i> confirmation is needed.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"2239-2244"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Some minutes matter more: Groin-to-recanalization is the main time-related predictor of outcome in acute ischemic stroke.","authors":"Antonio De Mase, Emanuele Spina, Giovanna Servillo, Stefano Barbato, Giuseppe Leone, Flavio Giordano, Rosaria Renna, Angelo Ranieri, Walter Di Iorio, Massimo Muto, Gianluigi Guarnieri, Mario Muto, Paolo Candelaresi, Vincenzo Andreone","doi":"10.1177/15910199241282714","DOIUrl":"10.1177/15910199241282714","url":null,"abstract":"<p><p>IntroductionEndovascular thrombectomy (EVT) is the standard of care for selected patients with acute ischemic stroke (AIS) and large vessel occlusion (LVO), associated with intravenous thrombolysis, when indicated. While many studies focused on pre-hospital and in-hospital pathways, only few analyzed the relationship between groin-to-recanalization (GTR) time and functional outcome.AimTo explore whether GTR time is an independent predictor of outcome in patients undergoing EVT.MethodsAll patients with anterior circulation stroke treated with EVT at a high-volume center from January 2021 to December 2023 were included. The cohort was divided into two groups according to GTR time shorter or longer than 30 min. Regression analysis assessed the association between GTR time and 3-month good outcome, defined as modified Rankin Scale 0-2.ResultsThe study included 419 patients. The groups had similar baseline characteristics and similar onset to recanalization (OTR) time. Regression analysis showed shorter GTR time is an independent predictor of favorable outcome (OR 2.49 [95% CI 1.26-4.94]). Age, baseline NIHSS, ASPECT score and bridging IVT were also found to be independently associated with outcome.Discussion and conclusionsOur study showed GTR time is an independent predictor of good outcome in patients undergoing EVT with similar OTR time, emphasizing procedural time as a key prognostic factor, even greater than other well-known pre-hospital and in-hospital time-dependent variables. These findings may raise the issue of developing alternative approaches or early \"rescue\" strategies for complicated procedures.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"2401-2406"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilization of high-support pre-shaped guiding catheter (SEL-E and IWATE series) in neuroendovascular treatment.","authors":"Kohei Takikawa, Naoto Kimura, Satsuki Nakajima, Takuji Sonoda, Michiko Yokosawa, Takayuki Sugawara, Takahiko Kikuchi","doi":"10.1177/15910199251345629","DOIUrl":"10.1177/15910199251345629","url":null,"abstract":"<p><p>BackgroundGuiding catheters (GCs) are crucial platforms for neuroendovascular procedures. High-support pre-shaped guiding catheters (HPGCs) were designed to address access difficulties in complex anatomies. Given its versatility in neuroendovascular treatment, we report our single-center experience with the HPGCs.MethodsA single-center retrospective analysis was conducted on 154 neuroendovascular procedures using the HPGCs between January 2017 and February 2024. The HPGCs include three models: SEL-E, IWATE, and IWATE-L. The cases were categorized into three scenarios: addressing access failure, serving as a platform for posterior circulation interventions, and supporting angioplasty for neck-thoracic lesions. Data on procedural success, complications, and anatomical characteristics were collected.ResultsSuccessful access was achieved in 92.4% of access failure cases (n = 79). Successful recanalization was achieved in 60.5% of thrombectomy cases, with a median patient age of 89 years and complex vascular anatomies involving a type 3 aorta in 94.2% of cases. For posterior circulation procedures (n = 67), the treatment success rate was 97.0%, utilizing a strategy that combined the HPGCs with intermediate catheters to prevent large-bore GCs from entering the vertebral artery. In angioplasty for neck-thoracic lesions (n = 8), technical success was achieved in 75% of patients.ConclusionsThe pre-shaped, high-support features of the HPGCs demonstrated effectiveness and safety in access failure cases while enabling broader utilization in posterior circulation and neck-thoracic lesion procedures.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"2801-2810"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A prospective, randomized, controlled, interventional clinical trial to evaluate the safety and efficacy of the medical monopoint reperfusion system for aspiration thrombectomy in acute ischemic stroke patients (SUMMIT MAX): Trial rationale and design.","authors":"Guilherme Dabus, Ajit S Puri, Ben McGuinness, Ryan A Priest, Ansaar T Rai, Bradley A Gross, Osama O Zaidat, Ricardo A Hanel, M Shazam Hussain, Hamza A Shaikh, Joey D English, Thanh N Nguyen","doi":"10.1177/15910199241270711","DOIUrl":"10.1177/15910199241270711","url":null,"abstract":"<p><p>BackgroundTreatment of large vessel occlusion (LVO) using mechanical thrombectomy with or without intravenous thrombolysis has demonstrated better outcomes compared to medical treatment alone. Large-bore aspiration catheters have been recently introduced. Their effectiveness and safety have not been demonstrated in a randomized trial. The SUMMIT MAX study is designed to address this question.MethodsSUMMIT MAX is a randomized controlled trial where the effectiveness and safety of the large-bore Monopoint Reperfusion system (Route 92 Medical, San Mateo, CA), will be compared to the currently largest available FDA-cleared aspiration thrombectomy device the AXS Vecta Aspiration system (Stryker Neurovascular, Fremont, CA). The study is a multi-center, prospective, randomized, controlled, interventional, open label clinical trial. The hypothesis is that the effectiveness measured by the recanalization rate (modified thrombolysis in cerebrovascular infarction - mTICI) and safety measured by symptomatic intracranial hemorrhage rate (sICH) of the medical monopoint reperfusion system is non-inferior to the AXS Vecta Aspiration system.ResultsUp to 250 subjects are enrolled with at least 50% of subjects enrolled by US sites. The primary effectiveness endpoint is successful arterial revascularization defined as an mTICI score ≥ 2b after use of the assigned device adjudicated by an independent core lab. The primary safety endpoint is defined as sICH within 24 h (-8/+24) post-procedure. Secondary endpoints include successful arterial revascularization defined as a mTICI score ≥ 2b after use of the assigned device with or without adjunctive therapy; device-related serious adverse events; all asymptomatic hemorrhages; time from groin puncture to final angiogram; and rate of first pass effect defined as mTICI 2b after first pass with the assigned device stratified by age (≤85, ≥ 86).ConclusionSUMMIT MAX is a randomized controlled trial comparing the effectiveness and safety of a new large bore class of aspiration devices to the currently largest FDA-cleared aspiration device available.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"2345-2352"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}