Abstract Number ‐ 165: Are Smaller Stentrievers the Answer for Achieving Procedural Success in Distal Vessel Occlusions (DiVO)?

Abstract

Introduction Distal vessel occlusions (DiVO) represent the next frontier of interventional stroke care. Although many experts agree the current generation of stentrievers appear to be ill‐suited to address challenges presented by DiVO, some practitioners advocate utilizing smaller devices.We sought to examine whether smaller diameter devices (3,4 or 5 mm) had any edge over standard sized 6 mm device. Methods A prospectively maintained neuro‐endovascular database was queried for patients between January 2013 to August 2022. Patients included in the analysis had undergone mechanical thrombectomy of distal circulation defined as M2, M3, P2, P3, A2 and A3 segments of the MCA, PCA, and ACA respectively.Primary outcomes measured were TICI post procedure, mRS at discharge and mRS at 90 days. Results A total of 33 patients with DiVO were identified out of a database containing 826 mechanical thrombectomies. There were no other differences in baseline characteristics such as presentation NIHSS (p = 0.58) or comorbid medical conditions. We found no differences in post procedure recanalization TICI between large device and small devices cohorts (p = 1.00), symptomatic ICH (p = 0.52), mRS at discharge (p = 0.154) and mRS at 90 days (p = 0.22). Conclusions There do not appear to be any clinical or radiographic difference in utilizing smaller diameter stentrievers in setting of DiVO.