Millipede 88 and Millipede 70 catheters for contact aspiration thrombectomy in acute stroke: A multicenter experience

BackgroundAspiration is rapidly becoming the first-line strategy for mechanical thrombectomy for LVOs. Superbore aspiration catheters (lumen ≥ 0.088") have been suggested to provide advantages over conventional aspiration including improved recanalization and reduced distal emboli owing to distal flow control. The objective of this study was to assess the technical feasibility and safety of contact aspiration using the novel Millipede88 Superbore catheter and the Millipede70 catheter.MethodsA retrospective analysis of consecutive cases using the Millipede88 Superbore catheter as first-line for the treatment of large vessel occlusions was conducted. Key outcome parameters assessed were navigation to target occlusion, recanalization success, procedure-related complications, NIHSS, and symptomatic intracranial hemorrhage at 24 h.Results26 patients were treated using Millipede catheters. The first-pass effect, defined as mTICI ≥ 2c reperfusion using contact aspiration, was achieved in 69% of cases. mTICI ≥ 2c at final angiography was obtained in 88% of cases. Contact aspiration alone was used in 92% of cases. No catheter-related complications, such as dissections or perforations, or embolization to new territory was reported. sICH did not occur in any of the cases. The median drop in NIHSS at 24 h was eight points.ConclusionsIn the majority of cases, aspiration using the Millipede88 catheter results in excellent recanalization with one pass, with an excellent safety profile. These data suggest that aspiration thrombectomy using the Millipede88 Superbore catheter is feasible and safe. A large prospective trial of Millipede88 for aspiration thrombectomy is underway.