Abstract 048: The Tigertriever 13 for Primary Distal Vessel Occlusions (DVO) ‐ Multicenter Experience

Abstract

Introduction Objective: To evaluate the safety and efficacy of the Tigertriever 13 stent retriever in acute ischemic stroke (AIS) patients with primary distal and medium vessel occlusions (DMVO). Tigertriever 13 is a low profile stentriever that enables using a small microcatheter for safer procedures. Methods This is a retrospective data analysis of consecutive 59 cases performed between 04/19‐12/22 in two German comprehensive stroke centers. These patients were either ineligible or failed thrombolysis. Mean age was 75 and pre‐procedure NIHSS was 8,2 (SD 5,1), 55,9% Male, 37,2% were treated and failed thrombolysis treatment. These patients were admitted with disabling deficits that localize to the territory of the distal vessels. The occluded locations were 58,0% MCA M3, 0,0% MCA M4, 22,0% ACA, 20,0% PCA. All patients were treated with Tigertiever 13 with a mean of 1,7 passes where 100% under general anesthesia. Successful recanalization of the occluded vessel was measured by TICI score and intraoperative complications were recorded for safety evaluation. Results The mean time from symptoms onset to groin puncture was 200 minutes, and a successful recanalization rate of TICI 2b‐3 was observed in 72,8% of the patients while NIHSS was improved from 8,2 at baseline to 5,7 at discharge. There were 11,8% asymptomatic intracranial hemorrhages (ICH) and 0,5% symptomatic ICH. Conclusion The Tigertriever 13 device with operator controllability and high fluoroscopy visibility and its small size can potentially provide a safe and effective clot removal in patients with distal vessels occlusion. The effectiveness and safety profile in these patients with distal occlusions is comparable to those of patients with proximal occlusions.