Waveform-assisted navigation (WAN) technique to visualize the appropriate position of the aspiration catheter to the thrombus during mechanical thrombectomy

Endovascular thrombectomy has become an established treatment for acute ischemic stroke caused by large vessel occlusion, significantly improving clinical outcomes in eligible patients. Advances in thrombectomy techniques have improved recanalization rates, with newer tools enabling faster and more effective clot retrieval1 . The various techniques employed include stent retriever only, aspiration catheter and stent retriever, and direct aspiration2 . Whether using direct aspiration or stent retriever with contact aspiration, achieving optimal recanalization requires direct and secure contact between the aspiration catheter and the thrombus3 . Proper engagement of the catheter with the clot is critical for efficient aspiration and subsequent vessel recanalization. However, it is impossible to visually confirm whether the aspiration catheter is appropriately in contact with the thrombus. In this report, we introduce a novel approach termed the waveform-assisted navigation (WAN) technique, which uses pressure waveforms to confirm and visualize the secure apposition of the aspiration catheter to the thrombus during thrombectomy(video 1). Video 1 Waveform-Assisted Navigation (WAN) technique