A back and forth manual aspiration technique using a SOFIA Plus catheter for acute ischemic stroke: technical note

Purpose We describe a new modification of thromboaspiration to facilitate recanalization, referred to as the “back and forth” manual aspiration technique. Methods In this technique, the aspiration catheter (SOFIA Plus catheter, MicroVentionInc, Tustin, CA, USA) is positioned adjacent to the occluded segment and then advanced over the thrombus during manual aspiration with a 50-cc syringe. Results We evaluated this technique in 15 patients who presented to our institution with acute ischemic stroke (AIS). Final mTICI 2b/3 was achieved in 86.6% of the patients with the sole use of this new aspiration technique. No dissection, rupture, or downstream emboli were associated with the procedure. The mean time from puncture to revascularization was 35 min. Conclusion This modified technique with back and forth movements of the SOFIA Plus catheter over the thrombus during aspiration may facilitate thrombectomy in AIS. However, further studies in larger groups are necessary to elucidate its efficacy and to compare with current techniques.