Neurointervention.  2023 Mar;18(1):47-57. 10.5469/neuroint.2022.00283.

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

• Settecase F
• Kim WT
• English JD

• KMID: 2539946
• DOI: http://doi.org/10.5469/neuroint.2022.00283

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.

Keyword

Stroke; Thrombectomy; Equipment and supplies; Ischemia

Figure

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  Fig. 1. (A) Initial cerebral angiogram showing an occlusion at the M1 segment of the right middle cerebral artery. (B, C) The delivery of the AXS Vecta 74 catheter (Stryker Neurovascular, Fremont, CA, USA) (black arrows) to the occlusion site over a Tenzing 7 delivery catheter (Route 92 Medical, San Mateo, CA, USA) (white arrow). (D, E) Final cerebral angiography imaging showing successful recanalization (mTICI score 3). (F) Photo of retrieved thrombus. mTICI, modified thrombolysis in cerebral ischemia score.

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