Utilization of the large-bore Penumbra JET 7 reperfusion catheter in thrombectomy for acute ischemic stroke: A single-center experience

Amireh, Abdallah; Kuybu, Okkes; Adeeb, Nimer; Kelley, Roger E.; Javalkar, Vijayakumar; Cuellar‐Saenz, Hugo; Sharma, Pankaj

doi:10.1177/1591019920942364

Cited by 11 publications

(6 citation statements)

References 25 publications

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“…Ultimately, 30 studies including 3228 patients met final inclusion criteria for the meta-regression (table 1). 3–32 Twenty of these studies were single center retrospective analyses, while nine were multicenter and retrospective in design, and one study was a multicenter prospective study.…”

Section: Resultsmentioning

confidence: 99%

Impact of aspiration catheter size on clinical outcomes in aspiration thrombectomy

Schartz

Ellens²,

Kohli³

et al. 2022

J NeuroIntervent Surg

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BackgroundDirect aspiration thrombectomy is a well-established method for mechanical thrombectomy in acute ischemic stroke. Yet, the influence of aspiration catheter internal diameter (ID) on aspiration thrombectomy efficacy is incompletely understood.MethodsA systematic literature review and meta-regression analysis was completed to evaluate the impact of primary aspiration thrombectomy outcomes based on the ID of the aspiration catheter. Primary outcome measures were: final recanalization of modified Thrombolysis In Cerebral Ischemia (mTICI) 2b-3 with aspiration only and with rescue modalities, first pass effect (FPE), need for rescue modalities, intracranial hemorrhagic complication rates, and functional outcomes of 90-day modified Rankin Scale (mRS) of 0–2.Results30 studies were identified with 3228 patients. Meta-regression analysis revealed a significant association between increasing aspiration catheter ID and FPE (p=0.032), between ID and final recanalization with aspiration only (p=0.05), and between ID size and recanalization including cases with rescue modalities (p=0.002). Further, subgroup analysis indicated that catheters with an ID ≥0.064 inch had a lower rate of need for rescue than smaller catheters (p=0.013). Additionally, catheters with an ID ≥0.068 inch had a higher rate of intracranial bleeding complications (p=0.025). Lastly, no significant association was found in functional outcomes overall.ConclusionsLarger aspiration catheters are associated with a higher rate of FPE, final recanalization with only an aspiration catheter, and in cases with rescue modalities, though with a higher rate of hemorrhagic complications. These findings confirm that aspiration catheter size functions as a variable in aspiration thrombectomy, which should be considered in future study and trial design.

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Section: Resultsmentioning

confidence: 99%

Impact of aspiration catheter size on clinical outcomes in aspiration thrombectomy

Schartz

Ellens²,

Kohli³

et al. 2022

J NeuroIntervent Surg

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“…Subtle specification differences between catheters exist ( Table 3 ). Studies of clinical experience with these catheters has yielded similar rates of efficacy (reperfusion rates, number of passes, procedure times, outcomes), and safety (procedural complications) to AXS Vecta 71 [ 27 , 40 - 42 ]. There are no published clinical studies utilizing RED72 catheters at this time.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, available aspiration catheter ID now range between 0.035 inches and up to 0.074 inches. [27][28][29][30][31] The AXS Vecta 71 and AXS Vecta 74 (Stryker Neurovascular, Fremont, CA, USA) aspiration catheters were recently approved for thrombectomy, with an ID of 0.071 inches and 0.074 inches, respectively. The Vecta 071 can be delivered through a 0.088-inch guide catheter or larger.…”

Section: Introductionmentioning

confidence: 99%

“…Use of larger catheters with ADAPT (0.070 inch or greater) may be associated with increased aspiration flow rates, first pass effect, faster recanalization, reduced procedure time, and better reperfusion rates [ 25 , 26 ], compared to less sizes than 0.070. Currently, available aspiration catheter ID now range between 0.035 inches and up to 0.074 inches [ 27 - 31 ]. The AXS Vecta 71 and AXS Vecta 74 (Stryker Neurovascular, Fremont, CA, USA) aspiration catheters were recently approved for thrombectomy, with an ID of 0.071 inches and 0.074 inches, respectively.…”

Section: Introductionmentioning

confidence: 99%

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

2023

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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.

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“…Additionally, successful recanalization rate was comparable to that of previous studies using stent-retrievers [ 11 ]. The use of JET 7 has been demonstrated to be safe and effective in different thrombectomy techniques and in other occlusion site (M1, M2, P1 segments) with mTICI 2b/3 achieved in 86% [ 12 , 13 ]. Limitations were: a retrospective, non-consecutive design; limited number of cases; lack of a first-line stent retriever control group.…”

Section: Discussionmentioning

confidence: 99%

Technical note and first results on JET 7 thromboaspiration device for T-ICA occlusions

et al. 2022

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Background To describe technical features and initial results of a novel large-bore reperfusion catheter as first thromboaspiration approach for endovascular stroke treatment in terminal internal carotid artery (T-ICA) occlusions. Methods All patients treated with A Direct Aspiration first-Pass Technique (ADAPT) using JET 7 “Standard Tip” Penumbra Reperfusion catheter for acute T-ICA occlusion were retrospectively included in the study. Baseline data, puncture to recanalization time, number of attempts, switch to second device/technique rate and successful recanalization rate were assessed. Successful recanalization was defined by a thrombolysis in cerebral infarction (TICI) score ≥ 2b and favorable functional outcome was defined according to modified Rankin scale (score, 0–2). Catheter specifics and thromboaspiration reperfusion technique with JET 7 were reported. Results A total of 21 patients who underwent ADAPT with JET 7 Reperfusion catheter were enrolled for the final analysis. ADAPT was performed as first approach in all cases (100%). First attempt successful recanalization (eTICI ≥2b) was obtained in 90,5% of cases. Mean puncture to recanalization time was 16 minutes. Final successful recanalization was reached in 96.5%. Functional independence at 90 was achieved in 57,1% cases. Symptomatic intracranial hemorrhage occurred in one patient within 24 h. Conclusion The large-bore JET 7 reperfusion catheter could be considered as first-line in patients with acute T-ICA occlusion, allowing rapid recanalization and low rate of rescue therapy with stent retriver. Further series and/or trial evaluation are required to confirm our results.

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Utilization of the large-bore Penumbra JET 7 reperfusion catheter in thrombectomy for acute ischemic stroke: A single-center experience

Cited by 11 publications

References 25 publications

Impact of aspiration catheter size on clinical outcomes in aspiration thrombectomy

Impact of aspiration catheter size on clinical outcomes in aspiration thrombectomy

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

Technical note and first results on JET 7 thromboaspiration device for T-ICA occlusions

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