Novel Atraumatic Catheters Enhance Safety and Efficacy in Mechanical Thrombectomy

Introduction Large, and even more Super Large Bore Aspiration (SLBA), have shown high rates of First‐Pass Efficacy (FPE) during mechanical thrombectomy. The utilization of the novel atraumatic delivery catheters has provided the adequate support to safely and efficiently reach the clot with large and super‐large bore catheters, without need for crossing the occlusion. Aim of Study We performed a comparison of the novel atraumatic delivery catheters actually on the market (SENDit, Penumbra Inc; Tenzing 7 and 8, Route 92 Medical; Cheetah, Q’apel; Zipline, Perfuze; Innerglide, J&J MedTech; Carrier SM, MD and LG, Balt) or in advanced testing phase (FastPass, Stryker) analyzing the different features, especially in combination with the paring aspiration catheters on the market (RED 72, Penumbra Inc; FreeClimb 70 & 88 and HiPoint 88, Route 92 Medical; Hippo 072, Q’apel; Millipede 088, Perfuze; Cereglide 71 & 92, J&J MedTech; Ballast 088, Balt) or in advanced testing phase (Broadway 84, Stryker). Methods These platforms entail the utilization of a triaxial assembly: guide/long sheath catheter with/without balloon, a 0.070"/72” or 0.084"/92" reperfusion catheter and an insert catheter that completely consumes the inner diameter of the large‐bore (LBA) or super large‐bore (SLBA) aspiration catheters. Results These novel atraumatic delivery catheters have proven their superior capability in navigating the matching reperfusion catheters to the proximal aspect of the occlusion. The virtually atraumatic self‐centering soft tapered tip is capable to cruise the tortuous cervical‐cranial vasculature. The extremely large shaft almost zeroes the step‐off with the aspiration catheters and reduces the risk to get stuck at vascular ledges/bifurcations, making unnecessary to cross the embolus, which significantly reduces the risk of downstream clot embolization. Conclusion Building scientific evidences has demonstrated the elevated safety and efficacy of this new generation of triaxial stroke‐dedicated platforms combining a large‐bore (LBA) or super large‐bore (SLBA) aspiration catheters to novel atraumatic and self‐centering delivery catheters.