Efficacy and safety of CatchView Mini stent retriever for mechanical thrombectomy in proximal and distal medium vessel occlusions

Background Medium vessel occlusion (MVO) mechanical thrombectomy (MT) has shown promising outcomes and safety profiles, comparable to those of large vessel occlusion thrombectomy. Objective To assess the efficacy and safety of the CatchView Mini (CVM) stent retriever (Balt, Montmorency, France) in patients with acute stroke with proximal and distal MVO (pMVO vs dMVO), respectively. Methods We analyzed retrospective data of consecutive patients with MVO who underwent MT with the CVM stent retriever. We categorized occlusions into pMVO group (segments A1, M2, and P1) versus dMVO group (segments A2, A3, M3, P2, and P3). Demographic, clinical, angiographic, and clinical outcome data (National Institute of Health Stroke Scale score at 24 hours and modified Rankin Scale (mRS) score at 3 months) were compared. The first pass effect (FPE) was defined as that which achieved modified Thrombolysis in Cerebral Infarction (mTICI) 2c–3 after a single device pass. Results A total of 196 patients were included (44.3% female, median (IQR) age 74 (67–84) years), of whom 151 (77%) had pMVO and 45 (23%) dMVO. FPE was achieved in 108 (55.1%) patients, and final successful reperfusion (mTICI 2c–3) was attained in 156 (79.6%) cases, with up to two passes in 78% of patients. Rescue MT was performed in 24 (12.2%) patients. The dMVO group had a higher FPE rate (84.4% vs 46.3%; P<0.001), fewer number of passes, and lower symptomatic hemorrhage rate (0% vs 0.6%; P=0.009) than the pMVO group. Around 75% of patients in both groups achieved similar favorable outcomes (mRS score 0–2) at 3 months. Conclusions The CVM device appears effective and safe for pMVO and dMVO thrombectomy.