Imperative Care has announced that new data from studies evaluating the utility of its Zoom stroke solution were recently presented at the ongoing Society of NeuroInterventional Surgery’s (SNIS) 19th annual meeting (25–29 July, Toronto, Canada).
Results from an independent, single-centre experience evaluating the association between guide catheter position and final reperfusion in patients who received aspiration thrombectomy for ischaemic stroke were presented by James Milburn (Ochsner Health, New Orleans, USA).
Findings from the study demonstrated that intracranial guide catheter placement in the petrous internal carotid artery (ICA) segment or further distal versus placement in the cervical ICA segment or more proximal was associated with a better rate of Thrombolysis in cerebral infarction (TICI) ≥2C reperfusion (82.7% compared to 60%, p=0.019, respectively), and a better first-pass effect (51.9% compared to 27.5%, p=0.021, respectively).
Access time to final recanalisation was significantly shorter in patients with intracranial guide catheter placement (23.8 minutes) compared to patients with proximal guide catheter placement (33.9 minutes), p=0.011, a press release from Imperative also details.
“The introduction of large-bore guide catheters that can track further in the brain has been a game-changer for the treatment of ischaemic stroke,” said Milburn. “These results further support that intracranial access is directly associated with improved reperfusion, or as evidenced by this study, final TICI 2C or better reperfusion rate. The Zoom 88 large distal platform has become my default guide catheter for stroke. Going further up into brain and closer to the clot with Zoom 88 results in enhanced navigation support and improves first-pass effect by losing clot less frequently and achieving quicker access in patients suffering emergent large vessel occlusions.”
Results from a study evaluating the effect of intracranial flow parameters using various guide catheters for aspiration thrombectomy were also presented by Holly Berns (Northern Arizona University, Flagstaff, USA) at SNIS 2022.
The study showed an 67% flow reduction in the middle cerebral artery (MCA) when a Zoom 88 access catheter was positioned distal to the posterior communicating artery and proximal to the carotid terminus. This flow reduction was significantly greater when compared to the 54% reduction achieved with an inflated balloon guide catheter positioned in the proximal ICA. In comparison, the study found that placing a long sheath in the proximal ICA resulted in approximately 30% flow reduction in the MCA, or less than half the flow reduction achieved with Zoom 88 at the carotid terminus.
“Significantly reduced flow locally at the thrombus location can meaningfully reduce potential downstream migration during mechanical thrombectomy,” said senior author of the study, Timothy Becker (Northern Arizona University, Flagstaff, USA). “The findings from this study demonstrate that distal placement of a Zoom 88 can translate to better flow reduction than a balloon guide catheter without substantial reduction to collateral or ipsilateral flow and the additional time required to set up the balloon placed proximally.”
One additional single-centre report on the Zoom stroke solution was presented by Milburn at the meeting, which evaluated an aspiration-first approach using Zoom catheters in patients with ICA, M1 and M2 occlusions. The study found that the use of angled tip aspiration catheters for thrombectomy was associated with quicker time to final reperfusion, lower use of stent retrievers, and lower use of additional aspiration catheters, suggesting a reduction in procedure cost.
Additionally, data from a multicentre retrospective review of 58 consecutive patients who underwent venous sinus stenting for idiopathic intracranial hypertension were presented by Shahid Nimjee (The Ohio State University Wexner Medical Center, Columbus, USA). In this report, Imperative’s TracStar large distal platform (LDP) technology was used to provide access to intracranial vasculature and was advanced to the location of the stent placement in 97.9% of cases.
As per the Imperative release, results from the study indicated that TracStar LDP is a safe and effective access platform for patients with idiopathic intracranial hypertension who are candidates for stent placement. Authors of the study suggested that the high rate of technical success in accessing the pathology may be attributed to the unique design elements of the TracStar LDP, which combines the flexibility of a distal access catheter with the support of a long sheath in a single large 0.0880-inch intracranial access catheter.
