J Cerebrovasc Endovasc Neurosurg.  2022 Sep;24(3):241-248. 10.7461/jcen.2022.E2021.12.002.

Forced suction thrombectomy in patients with acute ischemic stroke using the SOFIA Plus device

Affiliations
  • 1Department of Neurosurgery, Chungnam National University Hospital, Deajeon, Korea
  • 2Department of Neurosurgery, Hurisarang Hospital, Daejeon, Korea
  • 3Department of Neurosurgery, Chungnam National University Sejong Hospital, Sejong, Korea

Abstract


Objective
Stent retrieval thrombectomy has recently been the standard treatment for acute ischemic stroke with large artery occlusion. However, the development of catheters for suction thrombectomy has recently led to results comparable to that of stent retrieval thrombectomy (SRT). This study aimed to analyze the safety and efficacy of forced suction thrombectomy (FST) using the SOFIA Plus (MicroVention Terumo, Tustin, CA, USA) device.
Methods
We included patients with acute ischemic stroke who underwent FST using the SOFIA Plus device at our institution. Medical records and angiographic data were reviewed, and the results of this study were compared with those of other FST studies.
Results
A total of 35 patients were included in this study. The occlusion sites were the internal carotid artery terminal (4), M1 segment (20), and posterior circulation (11). Of the 35 patients, FST was performed in only 21 (60%) patients, and the remaining 14 (40%) patients underwent SRT and FST. In all cases, the recanalization rate was 100%, and the average time from groin puncture to recanalization was 21±4.94 min. In particular, the average time required to reach the SOFIA Plus lesions from the groin puncture was 10.44±5.06 min and about 67% of the FST patients were recanalized at the first attempt. Three-months modified Rankin Scale (mRS) score of ≤2 was observed in 52% of the patients.
Conclusions
Forced suction thrombectomy using the SOFIA Plus yielded a high recanalization rate within a shorter time. In particular, the recanalization rate was higher than that reported in previous studies using other types of suction devices.

Keyword

Ischemic stroke; Thrombectomy; Aspiration; Catheter; Stent

Figure

  • Fig. 1. (A) Fluoroscopic image of SOFIA Plus placed at the occluded lesion via tortuous proximal vessel. (B) Fluoroscopic image of SOFIA Plus placed to M3 for distal embolic occlusion at M3.


Cited by  1 articles

Real-Time Visualization of Thrombus during Suction Thrombectomy : Contrast-in-Stasis Technique
Yoon-Soo Lee
J Korean Neurosurg Soc. 2024;67(4):477-482.    doi: 10.3340/jkns.2023.0158.


Reference

1. Berkhemer OA, Fransen PS, Beumer D, van den Berg LA, Lingsma HF, Yoo AJ, et al. A randomized trial of intraarterial treatment for acute ischemic stroke. N Engl J Med. 2015; Jan. 372(1):11–20.
2. Campbell BC, Mitchell PJ, Kleinig TJ, Dewey HM, Churilov L, Yassi N, et al. Endovascular therapy for ischemic stroke with perfusion-imaging selection. N Engl J Med. 2015; Mar. 372(11):1009–18.
Article
3. Gory B, Bresson D, Kessler I, Perrin M, Guillaudeau A, Durand K, et al. Histopathologic evaluation of arterial wall response to 5 neurovascular mechanical thrombectomy devices in a swine model. AJNR Am J Neuroradiol. 2013; Nov-Dec. 34(11):2192–8.
Article
4. Goyal M, Demchuk AM, Menon BK, Eesa M, Rempel JL, Thornton J, et al. Randomized assessment of rapid endovascular treatment of ischemic stroke. N Engl J Med. 2015; Mar. 372(11):1019–30.
Article
5. Hu YC, Stiefel MF. Force and aspiration analysis of the ADAPT technique in acute ischemic stroke treatment. J Neurointerv Surg. 2016; Mar. 8(3):244–6.
Article
6. Jang HG, Park JS, Lee JM, Kwak HS. Initial experience of ACE68 reperfusion catheter in patients with acute ischemic stroke related to internal carotid artery occlusion. J Korean Neurosurg Soc. 2019; Sep. 62(5):545–50.
Article
7. Jankowitz B, Grandhi R, Horev A, Aghaebrahim A, Jadhav A, Linares G, et al. Primary manual aspiration thrombectomy (MAT) for acute ischemic stroke: safety, feasibility and outcomes in 112 consecutive patients. J Neurointerv Surg. 2015; Jan. 7(1):27–31.
Article
8. Jeon JP, Kim SE, Kim CH. Primary suction thrombectomy for acute ischemic stroke: a meta-analysis of the current literature. Clin Neurol Neurosurg. 2017; Dec. 163:46–52.
Article
9. John S, Hussain MS, Toth G, Bain M, Uchino K, Hui FK. Initial experience using the 5MAX™ ACE reperfusion catheter in intra-arterial therapy for acute ischemic stroke. J Cerebrovasc Endovasc Neurosurg. 2014; Dec. 16(4):350–7.
Article
10. Jovin TG, Chamorro A, Cobo E, de Miquel MA, Molina CA, Rovira A, et al. Thrombectomy within 8 hours after symptom onset in ischemic stroke. N Engl J Med. 2015; Jun. 372(24):2296–306.
Article
11. Kabbasch C, Möhlenbruch M, Stampfl S, Mpotsaris A, Behme D, Liebig T. First-line lesional aspiration in acute stroke thrombectomy using a novel intermediate catheter: initial experiences with the SOFIA. Interv Neuroradiol. 2016; Jun. 22(3):333–9.
Article
12. Kallmes DF, Sadasivan C, Fiorella D. The truth and fiction in aspiration physics: may the forces be with you. J Neurointerv Surg. 2018; Nov. 10(11):1029–30.
Article
13. Kang DH, Hwang YH, Kim YS, Park J, Kwon O, Jung C. Direct thrombus retrieval using the reperfusion catheter of the penumbra system: forced-suction thrombectomy in acute ischemic stroke. AJNR Am J Neuroradiol. 2011; Feb. 32(2):283–7.
Article
14. Kim YS, Kwak HS, Chung GH, Hwang SB. Manual aspiration thrombectomy using the Penumbra catheter in patients with acute M1 occlusion: a single-center study. Interv Neuroradiol. 2015; Dec. 21(6):694–9.
Article
15. Kowoll A, Weber A, Mpotsaris A, Behme D, Weber W. Direct aspiration first pass technique for the treatment of acute ischemic stroke: initial experience at a European stroke center. J Neurointerv Surg. 2016; Mar. 8(3):230–4.
Article
16. Lapergue B, Blanc R, Guedin P, Decroix JP, Labreuche J, Preda C, et al. A direct aspiration, first pass technique (ADAPT) versus stent retrievers for acute stroke therapy: an observational comparative study. AJNR Am J Neuroradiol. 2016; Oct. 37(10):1860–5.
Article
17. Lee HC, Kang DH, Hwang YH, Kim YS, Kim YW. Forced arterial suction thrombectomy using distal access catheter in acute ischemic stroke. Neurointervention. 2017; Mar. 12(1):45–9.
Article
18. Powers WJ, Derdeyn CP, Biller J, Coffey CS, Hoh BL, Jauch EC, et al. 2015 American Heart Association/American Stroke Association focused update of the 2013 guidelines for the early management of patients with acute ischemic stroke regarding endovascular treatment: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2015; Oct. 46(10):3020–35.
Article
19. Romano DG, Cioni S, Vinci SL, Pero G, Comelli C, Comai A, et al. Thromboaspiration technique as first approach for endovascular treatment of acute ischemic stroke: initial experience at nine Italian stroke centers. J Neurointerv Surg. 2017; Jan. 9(1):6–10.
Article
20. Sakai N, Ota S, Matsumoto Y, Kondo R, Satow T, Kubo M, et al. Efficacy and safety of REVIVE SE thrombectomy device for acute ischemic stroke: river Japan (reperfuse ischemic vessels with endovascular recanalization device in Japan). Neurol Med Chir (Tokyo). 2018; Apr. 58(4):164–72.
Article
21. Saver JL, Goyal M, Bonafe A, Diener HC, Levy EI, Pereira VM, et al. Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke. N Engl J Med. 2015; Jun. 372(24):2285–95.
Article
22. Saver JL, Jahan R, Levy EI, Jovin TG, Baxter B, Nogueira RG, et al. Solitaire flow restoration device versus the Merci Retriever in patients with acute ischaemic stroke (SWIFT): a randomised, parallel-group, non-inferiority trial. Lancet. 2012; Oct. 380(9849):1241–9.
Article
23. Stampfl S, Kabbasch C, Müller M, Mpotsaris A, Brockmann M, Liebig T, et al. Initial experience with a new distal intermediate and aspiration catheter in the treatment of acute ischemic stroke: clinical safety and efficacy. J Neurointerv Surg. 2016; Jul. 8(7):714–8.
Article
24. Suzuki K, Aoki J, Sakamoto Y, Kanamaru T, Abe A, Suda S, et al. Efficiency of the penumbra 5MAX ACE reperfusion catheter in acute ischemic stroke patients. J Stroke Cerebrovasc Dis. 2016; Dec. 25(12):2981–6.
Article
25. Turk AS, Frei D, Fiorella D, Mocco J, Baxter B, Siddiqui A, et al. ADAPT FAST study: a direct aspiration first pass technique for acute stroke thrombectomy. J Neurointerv Surg. 2014; 6:260–4.
Article
26. van Swieten JC, Koudstaal PJ, Visser MC, Schouten HJ, van Gijn J. Interobserver agreement for the assessment of handicap in stroke patients. Stroke. 1988; May. 19(5):604–7.
Article
27. Vargas J, Spiotta A, Fargen K, Turner R, Chaudry I, Turk A. Long term experience using the ADAPT technique for the treatment of acute ischemic stroke. J Neurointerv Surg. 2017; May. 9(5):437–41.
Article
28. Wessell AP, Cannarsa G, Carvalho H, Kole MJ, Sharma P, Le EJ, et al. Thrombectomy for acute ischemic stroke with the new Sofia 6-French PLUS distal access reperfusion catheter: a single-center experience. Neuroradiol J. 2020; Feb. 33(1):17–23.
Article
29. Zaidat OO, Yoo AJ, Khatri P, Tomsick TA, von Kummer R, Saver JL, et al. Recommendations on angiographic revascularization grading standards for acute ischemic stroke: a consensus statement. Stroke. 2013; Sep. 44(9):2650–63.
Article
Full Text Links
  • JCEN
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr