J Cerebrovasc Endovasc Neurosurg.  2024 Sep;26(3):260-264. 10.7461/jcen.2024.E2023.09.003.

Optimizing suction force in mechanical thrombectomy: Priming the aspiration tubing with air versus saline

• Wali AR
• Sindewald RW
• Brandel MG
• Bravo J
• Steinberg JA
• Pannell JS
• Khalessi AA
• Santiago-Dieppa DR

• KMID: 2559435
• DOI: http://doi.org/10.7461/jcen.2024.E2023.09.003

Abstract

Objective
We sought to investigate how priming the tube between air versus air mixed with saline ex vivo influenced suction force. We examined how priming the tube influenced peak suction force and time to achieve peak suction force between both modalities.
Methods
Using a Dwyer Instruments (Dwyer Instruments Inc., Michigan City, IN, USA), INC Digitial Pressure Gauge, we were able to connect a .072 inch aspiration catheter to a rotating hemostatic valve and to aspiration tubing. We recorded suction force measured in negative inches of Mercury (inHg) over 10 iterations between having the aspiration tube primed with air alone versus air mixed with saline. A test was used to compare results between both modalities.
Results
Priming the tube with air alone compared to air mixed with saline was found to have an increased average max suction force (-28.60 versus -28.20 in HG, p<0.01). We also identified a logarithmic curve of suction force across time in which time to maximal suction force was more prompt with air compared with air mixed with saline (13.8 seconds versus 21.60 seconds, p<0.01).
Conclusions
Priming the tube with air compared to air mixed with saline suggests that not only is increased maximal suction force achieved, but also the time required to achieve maximal suction force is less. This data suggests against priming the aspiration tubing with saline and suggests that the first pass aspiration primed with air may have the greatest suction force.

Keyword

Aspiration thrombectomy; Strokes; Cerebrovascular accident; Suction; Endovascular procedures; Hydrodynamics

Figure

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  Fig. 1. Experimental setup with catheter, pressure gauge, connective tubing, and vacuum source.

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  Fig. 2. Suction force data at key time points (1, 5, 10 seconds and Tmax) and corresponding best fit curves with equation and Pearson Correlation Coefficients.

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