AXS Vecta 0.071–0.074 Inch Aspiration Catheters for Mechanical Thrombectomy: Case Series and Literature Review

Abstract

Aspiration catheters are widely used for thrombectomy either alone or in combination with a stent-retriever, with a distal inner diameter and trackability keys to their success. In an illustrative case series, we report our clinical experience with AXS Vecta (Stryker Neurovascular, Fremont, CA, USA), available in both 0.071-inch and 0.074-inch distal inner diameters, including the first 2 Vecta 74 cases reported. A literature review on AXS Vecta is also provided. In our series, 9 thrombectomies were performed (Vecta 71: 2 M1, 5 M2 occlusions; Vecta 74: 1 M1 and 1 ICA-terminus occlusion). The AXS Vecta was successfully delivered to the target site in all cases. In 7 of 9 cases, the catheter was delivered over a Tenzing 7 delivery catheter (Route 92 Medical, San Mateo, CA, USA). For 2 of 9 combination approach cases, Vecta was delivered using the stent-retriever wire as a rail. The median improvement in NIHSS score during hospitalization was 9 (IQR 5–12). Successful mTICI 2C or 3 recanalization was achieved in 8 of 9 (89%) patients after a median 2 (IQR 1–2) passes. Our median groin-to-reperfusion time was 23 (IQR 12.5–32) minutes, with no procedural complications. Two previous clinical studies of a total of 29 patients treated with Vecta 71 reported successful mTICI 2b–3 recanalization in 89–90% of cases. The Median groin-to-reperfusion time was 30 minutes. Complications were seen in 2 of 29 (6.9%) cases (vessel perforation and/or intracerebral hemorrhage). These data support the efficacy, deliverability, and safety of AXS Vecta for mechanical thrombectomy.

Initial Experience Using the New pHLO 0.072-inch Large-Bore Catheter for Direct Aspiration Thrombectomy in Acute Ischemic Stroke

“…The rates of procedural success and recanalization at the first attempt, along with the null incidence of complications related to REACT catheters, demonstrate the safety and effectiveness of the devices, in terms of clinical experience [ 25 ]. Another recent study [ 26 ] reported initial experience in 9 patients with AXS Vecta 71 and 74 for mechanical thrombectomy using aspiration and combination techniques for the purpose of assessing their safety and efficacy, resulting in successful revascularization in a similar proportion of cases as previously published studies (89%), using both ADAPT and the stent-retriever plus a local aspiration technique, without complications.…”