Introduction: The development of new revascularization devices has significantly improved recanalization rates and time to recanalization. A direct aspiration first-pass (ADAPT) technique for stroke thrombectomy was recently shown to be an effective and rapid way to achieve revascularization. The technique focuses on engaging and removing the clot without the use of a separator or retriever. It relies on the force and aspiration generated by the catheter. We sought to compare the physical and fluid dynamic properties, force and aspiration, of commercially available catheters to determine the most effective catheter for the ADAPT technique.
Methods: Aspiration for each catheter was measured by submersing the catheter into a graduated cylinder and aspirating water at room temperature. The volume of fluid aspirated, a direct correlation of flow, was compared for each catheter.
Force of aspiration at the tip of each catheter was measured and compared. Pressure at the tip of each catheter was measured utilizing a vacuum pressure gauge while the catheter was attached to a standard aspiration pump set to -29 inHg. Force was then calculated utilizing the formula P = F/A (P = pressure, F = Force, A = Area; catheter tip inner diameter).
Results: The data are presented in Table 1. The 5MAX ACE catheter had the greatest aspiration rate of all the catheters at 245 mL per min. The 5 MAX catheter aspirated 212 mL/min, followed by the Navian 058 and DAC 057 with 198 mL/min and 197 mL/min, respectively.
The 5MAX ACE generated the greatest tip force of 18.6 grams. The 5MAX had the least amount of force of 15.1 grams.
Conclusions: The physical and fluid dynamic properties of commercially available catheters suggest that the 5MAX ACE is the optimal catheter to employ for direct aspiration for stroke therapy.
Patient Care: It will optimize the choice of techniques to improve patient outcome
Learning Objectives: Determine the properties of commerically available catheters that are best suited for stroke therapy