Benefits of Large Bore Catheters in Interventional Stroke Treatment

Interventional treatment for stroke has rapidly evolved in recent years, driven by advances in catheter technology. Among the most significant innovations is the development of large bore catheters, which offer distinct advantages over conventional catheters in mechanical thrombectomy and aspiration procedures. Large bore catheters have been shown to improve clot retrieval efficacy, resulting in better patient outcomes, reduced procedure times, and increased success rates.

In this article, we will explore the benefits of large bore catheters, focusing on their greater aspiration force, flexibility, and the role of Hemo’s AsprAX Aspiration Catheter and EmerAX Intermediate Catheter as examples of cutting-edge solutions in stroke treatment.

Diagram of Large Bore Catheters in Interventional Stroke Treatment

1. Enhanced Aspiration Force for Efficient Clot Removal

One of the primary advantages of large bore catheters is their ability to generate significantly greater aspiration force when compared to conventional catheters. Aspiration force is directly related to the diameter of the catheter: a larger lumen allows for more efficient removal of clots by increasing the volume of blood and debris that can be aspirated using the same pressure. This can be especially critical when treating large vessel occlusions (LVOs), which often involve dense clots that are resistant to other forms of treatment.

For example, Hemo’s AsprAX Aspiration Catheter is designed with a large bore lumen that maximizes aspiration efficiency while maintaining a flexible tip for ease of navigation through the intricate neurovascular system. This combination of power and flexibility enables physicians to remove clots more effectively, even in challenging cases, without needing to increase vacuum pressures that might raise the risk of vessel damage.

2. Reduced Procedure Time and Improved Outcomes

By providing greater aspiration force and more efficient clot retrieval, large bore catheters can reduce procedure times during mechanical thrombectomy. Faster removal of the thrombus translates to quicker restoration of blood flow to the brain, which is crucial in limiting the extent of ischemic damage. Studies have shown that reducing the time from stroke onset to reperfusion directly correlates with better neurological outcomes and reduced long-term disability .

Additionally, using a large bore catheter reduces the need for multiple passes during thrombectomy, further decreasing the time patients spend in the intervention suite. Shorter procedures lower the risks associated with prolonged anesthesia and vascular manipulation, contributing to improved overall safety.

 

3. Flexibility and Trackability in Complex Vessels

While large bore catheters offer greater aspiration force, they also need to be highly flexible to navigate the tortuous pathways of the cerebrovascular system. This is where catheter design plays a pivotal role in achieving the right balance between a large lumen size and trackability.

Hemo’s EmerAX Intermediate Catheter is a prime example of a large bore catheter with a highly flexible tip. This design allows for seamless navigation through tight or curved vessels without compromising on the lumen size needed for effective aspiration. EmerAX’s soft tip minimizes the risk of vessel trauma, ensuring safer access to distal occlusions while still providing the benefits of a large bore for efficient clot retrieval.

4. Applicability Across Different Stroke Types

Large bore catheters, such as Hemo’s AsprAX and EmerAX, are versatile tools for stroke intervention, particularly in cases involving large vessel occlusions, where they excel in both aspiration and stent retriever-assisted thrombectomy procedures. Their use is not limited to any one technique; instead, these catheters can be utilized in various approaches, offering physicians greater flexibility and options during treatment.

 

Conclusion

The benefits of large bore catheters in stroke intervention are clear: they provide greater aspiration force, reduce procedure time, and offer flexibility in navigating complex vessels. These advantages make them an indispensable tool in the treatment of ischemic stroke, especially in cases of large vessel occlusion. Hemo’s AsprAX Aspiration Catheter and EmerAX Intermediate Catheter exemplify the next generation of large bore catheters, delivering both power and precision in stroke treatment. As catheter technology continues to evolve, large bore devices are poised to play an even greater role in improving patient outcomes and advancing the field of neurovascular interventions.

 

References:

  1. Saver, J.L., et al. (2015). “Stent-Retriever Thrombectomy after Intravenous t-PA vs. t-PA Alone in Stroke.” New England Journal of Medicine. 372(24), 2285-2295. https://www.nejm.org/doi/full/10.1056/NEJMoa1415061
  2. Goyal, M., et al. (2016). “Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials.” Lancet. 387(10029), 1723-1731. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)00163-X/abstract
  3. Turk, A.S., et al. (2019). “Large-Bore Aspiration Catheters in Acute Stroke Treatment: A Systematic Review of Their Efficacy and Safety.” Journal of NeuroInterventional Surgery. 11(7), 655-661.
  4. Nogueira, R.G., et al. (2018). “Thrombectomy 6 to 24 Hours after Stroke with a Mismatch between Deficit and Infarct.” New England Journal of Medicine. 378(1), 11-21. https://www.nejm.org/doi/full/10.1056/NEJMoa1706442