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Objectives <p>To evaluate the feasibility and safety of microcatheter aspiration thrombectomy (MAT) using a&#xa0;0.025″ microcatheter (PX-SLIM™) for distal vessel occlusions (DVOs) in acute ischemic stroke (AIS) with disabling deficits, and to explore outcome differences between patients with and without intravenous thrombolysis (IVT).</p> Methods <p>This retrospective multicenter study included 21&#xa0;highly selected AIS patients (July 2022–June 2024) with angiographically confirmed DVOs in the M3–M4, A3–A4, or P3–P4 segments. All had an Alberta Stroke Program Early CT Score (ASPECTS) of&#xa0;10 and disabling deficits and underwent MAT using the PX-SLIM™ microcatheter. Outcomes included clinical scores—National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS)—angiographic reperfusion using the modified Thrombolysis in Cerebral Infarction (mTICI; success ≥ 2b), and procedural safety.</p> Results <p>14&#xa0;patients (66.7%) received IVT + MAT and 7&#xa0;(33.3%) MAT alone. Successful reperfusion (mTICI ≥ 2b) was achieved in all 21&#xa0;patients (100%). Median NIHSS improved from 3&#xa0;at admission to 1&#xa0;at discharge and 0&#xa0;at 3&#xa0;months. At discharge, 90.5% had an mRS of&#xa0;1 and 9.5% an mRS of&#xa0;2; at 3&#xa0;months, 85.7% achieved mRS&#xa0;0 and 14.3% mRS 1.&#xa0;No hemorrhage, dissection, distal embolization, or AIS recurrence occurred; transient vasospasm was observed in 38% without clinical impact.</p> Conclusion <p>MAT using the PX-SLIM™ microcatheter appears to be a&#xa0;technically feasible approach with an acceptable safety profile in this small, highly selected cohort. The encouraging results are exploratory, and larger prospective studies are needed to confirm these findings.</p>

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Microcatheter Aspiration Thrombectomy with a 0.025″ Microcatheter for Distal Vessel Occlusions in Acute Ischemic Stroke with Disabling Deficits

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月19日

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  • Mohammad Almohammad,
  • Lisa Hekers,
  • Mete Dadak,
  • Ali Khanafer,
  • Mariana Gurschi,
  • Bayan Alhaj Moustafa,
  • Zakarya Ali,
  • Lars Timmermann,
  • Ole J. Simon,
  • Abdallah Aburub,
  • André Kemmling

摘要

Objectives

To evaluate the feasibility and safety of microcatheter aspiration thrombectomy (MAT) using a 0.025″ microcatheter (PX-SLIM™) for distal vessel occlusions (DVOs) in acute ischemic stroke (AIS) with disabling deficits, and to explore outcome differences between patients with and without intravenous thrombolysis (IVT).

Methods

This retrospective multicenter study included 21 highly selected AIS patients (July 2022–June 2024) with angiographically confirmed DVOs in the M3–M4, A3–A4, or P3–P4 segments. All had an Alberta Stroke Program Early CT Score (ASPECTS) of 10 and disabling deficits and underwent MAT using the PX-SLIM™ microcatheter. Outcomes included clinical scores—National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS)—angiographic reperfusion using the modified Thrombolysis in Cerebral Infarction (mTICI; success ≥ 2b), and procedural safety.

Results

14 patients (66.7%) received IVT + MAT and 7 (33.3%) MAT alone. Successful reperfusion (mTICI ≥ 2b) was achieved in all 21 patients (100%). Median NIHSS improved from 3 at admission to 1 at discharge and 0 at 3 months. At discharge, 90.5% had an mRS of 1 and 9.5% an mRS of 2; at 3 months, 85.7% achieved mRS 0 and 14.3% mRS 1. No hemorrhage, dissection, distal embolization, or AIS recurrence occurred; transient vasospasm was observed in 38% without clinical impact.

Conclusion

MAT using the PX-SLIM™ microcatheter appears to be a technically feasible approach with an acceptable safety profile in this small, highly selected cohort. The encouraging results are exploratory, and larger prospective studies are needed to confirm these findings.