Initial experience with delivery assist catheters as a new device class in mechanical thrombectomy in acute ischemic stroke

Purpose: To introduce a new device class "delivery assist catheter" and report first in vivo experience in acute ischemic stroke treatment. Methods: Retrospective data collection and analysis of stroke databases of two comprehensive stroke centers focusing on technical and angiographic parameters--primary endpoint defined as reaching the occlusion with a large-bore reperfusion catheter--from patients receiving endovascular stroke treatment using an AXS Offset[TM] delivery assist catheter (Stryker, Fremont, CA, USA) between May 2017 and November 2017. Results: Using the delivery assist catheter, a 6F catheter could be advanced to an intracranial occlusion for direct aspiration thrombectomy in 30 (88.2%) of a total of 34 patients (male: n = 14/34 (41.2%), age in years: mean (SD): 75 (11), median baseline NIHSS: 16 (interquartile range (IQR): 12-21)). In 4/34 (11.7%) cases the occlusion could not be reached with the aspiration catheter because of a preceding non-occlusive arteriosclerotic plaque (n = 1, 2.9%) or because of severe elongation and tortuosity of the arterial access route (n = 3, 8.8%). After aspiration thrombectomy mTICI 2b-3 was reached in 14/30 (46.7%) patients. In 21/34 (61.8%) patients (additional) stent-retriever-maneuvers (median: 1 (IQR: 0-2) were needed. In 28/34 (82.3%) patients final mTICI 2b-3 could be achieved. Conclusion: Delivery assist catheters to support large-bore reperfusion catheters for thromboaspiration in acute ischemic stroke are effective, in particular in case of vessel tortuosity and anatomic obstacles.