In 2016, Penumbra announced the launch of the ACE68 reperfusion catheter, part of the Penumbra System at the Society of NeuroInterventional Surgery 13th Annual Meeting (SNIS; 25–28 July, Boston, USA).
The ACE68 reperfusion catheter leverages tracking technology, with the intention of delivering maximum aspiration power easily and safely for extracting thrombus in acute ischaemic stroke patients.
NeuroNews interviews Kyriakos Lobotesis (Imperial College London, UK) about his experience using the new generation device.
What has changed in the ACE68 from the previous generation ACE64?
The ACE68 is a further improvement on what was already an unmatched aspiration system that tracks easily around tight curvatures (i.e. ophthalmic curve) to engage the clot. It is changes in the distal shaft that enables the ACE68 to track better than the ACE64. It does not only have the largest lumen to-date, but a new proprietary triple wire winding geometry, with optimised polymers and transitions that all synergistically facilitate this tracking.
What are the benefits?
The benefits are the larger lumen, which allows more powerful aspiration, combined with the ability to navigate through tortuous anatomy despite the large diameter of the catheter.
Can you describe a case in your experience where the ACE68 was particularly useful?
We recently treated a 98 year-old who developed a proximal MCA occlusion following an elective TAVI procedure. The ACE68 facilitated in the easy and rapid opening of the proximal artery despite the very tortuous anatomy. A more distal M2 occlusion was resolved using a smaller 3MAX catheter attached to the same Penumbra Pump MAX.
Have you had to adjust your standard technique since you began using the ACE 68?
Not at all. The procedure remains the same; it is just slightly easier and more effective.
Do you have any tips and tricks for using the ACE68 that you have picked up during your experience?
Nothing different to the prior generations of ACE. It is still important to use NeuronMAX 088 and deliver it to the high cervical and use the Pump MAX with the new Hi-Flow Aspiration Tubing to ensure the most aspiration power. I prefer to use the 3MAX to track the ACE68, as I was doing for the ACE64.
Is there still a need for the ACE64 in clinical practice?
There might still be situations where it would be helpful to use a smaller catheter depending on the vessel size.