Citations 2
Macrowire-only direct aspiration first-pass technique for endovascular mechanical thrombectomy: Multicenter technical series using the 0.035″ aristotle Colossus wire
Ares, William J. , Tonetti, Daniel A. , Koneru, Manisha , Dalkilic, Ahmet, Salah, Walid K. , Brinjikji, Waleed , Rajjoub, Kenan , Raz, Eytan, Khawaja, Ayaz , Southwood, Christopher, Dalyai, Richard , Birnbaum, Lee , Chowdhry, Shakeel , M., Huy , Joyce, Evan, Calnan, Daniel R. , Malek, Adel M. , Ares, William J , Tonetti, Daniel , Malek, Adel , Grandhi, Ramesh , Dalkilic, Ahmet, Raz, Eytan , Grandhi, Ramesh
Interventional Neuroradiology | May 22, 2025 | Volume: No volume available | Issue: No issue available | Pages: No page available
Background Larger “macrowires” may facilitate microcatheter-free delivery of large-bore aspiration catheters (ACs) for intracranial endovascular mechanical thrombectomy. We examined the safety and efficacy of the Aristotle Colossus Guidewire for this use. Methods In this retrospective analysis of prospective data from 12 institutions, we identified anterior circulation endovascular mechanical thrombectomy cases involving the Aristotle Colossus guidewire over a 12-month period. The primary efficacy endpoint was successful delivery of the AC to the site without the use of adjunct devices. Multivariable logistic regression was performed with clinically relevant covariables. Results In 122 patients (median age 74 years (interquartile range (IQR) 63–82)), most intracranial occlusions were in the M1 segment of the middle cerebral artery (95/122, 78.0%). The primary endpoint of microcatheter-free AC delivery was met in 87.7% (107/122) of patients; 93/122 (76.2%) patients underwent microcatheter-free delivery with successful reperfusion via contact aspiration (modified thrombolysis in cerebral infarction grade ≥ 2B). The median number of passes was 1 (IQR 1–2). Multivariable regression demonstrated that severe internal carotid artery tortuosity or cervical loop presence (odds ratio (OR): 0.09, 95% confidence interval (CI): 0.01–0.54, p = 0.01) and presence of intracranial atherosclerotic disease (OR: 0.15, 95% CI: 0.03–0.83, p = 0.03) were significantly associated with lower odds of successful AC delivery over the guidewire. Intraprocedural vasospasm occurred in 4.9% (6/122) of cases; there were no reports of vessel dissection or perforation. Conclusions We demonstrate the favorable performance of the Aristotle Colossus guidewire for anterior circulation ischemic stroke intervention. The macrowire appears to safely facilitate navigation of the neurovasculature by large-bore ACs without the need for microcatheter and/or stentriever.
A multicenter, propensity score-matched analysis of functional outcomes and recanalization success with or without Trevo for Medium and distal vessel occlusion
Siegler, James E. , Koneru, Manisha , Shaikh, Hamza, Salim, Hamza , Musmar, Basel , Adeeb, Nimer , Yedavalli, Vivek , Tjoumakaris, Stavropoula , Henninger, Nils , Sundararajan, Sri Hari , Tan, Benjamin Yong‐Qiang , Heit, Jeremy J , Regenhardt, Robert W. , Kass‐Hout, Tareq , Fiehler, Jens, Puri, Ajit S , Dyzmann, Christian , Barreau, Xavier, Renieri, Leonardo, Filipe, João Pedro , Harker, Pablo, Marotta, Thomas R. , Spears, Julian , Biswas, Arundhati , Clarençon, Frédéric, Abdalkader, Mohamad , Varela, Ricardo , Baker, Amanda , Altschul, David , Gonzalez, Nestor R. , Möhlenbruch, Markus A, Costalat, Vincent, Gory, Benjamin, Stracke, Christian Paul , Hecker, Constantin, Liebeskind, David S. , Alexandre, Andrea , Tancredi, Illario , Faizy, Tobias D. , Kalsoum, Erwah , Lubicz, Boris , Patel, Aman B. , Khalife, Jane, Rana, Ankit, Guenego, Adrien , Investigators, for the MAD MT, Heit, Jeremy J. , Salim, Hamza , Tjoumakaris, Stavropoula , Henninger, Nils , Kühn, Anna Luisa , Ghozy, Sherief , Scarcia, Luca , Regenhardt, Robert W , Morsi, Rami Z , Vigilante, Nicholas , Rouchaud, Aymeric , Essibayi, Muhammed Amir , Dyzmann, Christian , Colasurdo, Marco , Filipe, João Pedro , Alexandru Radu, Răzvan , Ota, Takahiro , Jabbour, Pascal , Klein, Piers , Nguyen, Thanh N , Altschul, David J , Gonzalez, Nestor R , Griessenauer, Christoph J , Liebeskind, David S. , Tancredi, Illario , Guenego, Adrien , Dmytriw, Adam A , Heit, Jeremy J , Musmar, Basel , Yedavalli, Vivek S , Siegler, James E , Tan, Benjamin Yq , Alexandre, Andrea M , Varela, Ricardo , Daraghma, Motaz , Kühn, Anna Luisa , Ghozy, Sherief , Morsi, Rami Z. , Cancelliere, Nicole M , Bernstock, Joshua D. , Rouchaud, Aymeric , Sheth, Sunil A , Essibayi, Muhammed Amir , Colasurdo, Marco , Barreau, Xavier , Renieri, Leonardo , Harker, Pablo , Radu, Răzvan Alexandru , Mowla, Ashkan , Jabbour, Pascal , Clarençon, Frédéric , Klein, Piers , Nguyen, Thanh N. , Möhlenbruch, Markus , Costalat, Vincent , Gory, Benjamin , Hecker, Constantin , Griessenauer, Christoph J. , Pedicelli, Alessandro , Mendes Pereira, Vitor , Khalife, Jane , Dmytriw, Adam A. , Investigators, for the MAD MT
Interventional Neuroradiology | May 21, 2025 | Volume: No volume available | Issue: No issue available | Pages: No page available
Background Endovascular therapy (EVT) for stroke due to distal or medium vessel occlusion (DMVO) is safe. Due to the distinct anatomical characteristics of DMVOs, further evaluation of EVT is crucial to determine which devices may yield better outcomes. Methods A retrospective analysis of adults with DMVO treated in 37 centers (11 countries) was queried. The primary outcome of favorable shift in 90-day modified Rankin Scale (mRS) was compared between patients treated with Trevo versus other devices on first pass using 1:1 propensity score matching (PSM) with multivariable adjustment. Secondary outcomes included the number of pass attempts, final thrombolysis in cerebral infarction (TICI) score 2b-3, symptomatic intracranial hemorrhage (sICH), improvement in National Institutes of Health Stroke Scale (NIHSS) at 24h, and 90-day mortality. Results Of the 1115 included patients, 264 (24%) were treated with Trevo (PSM cohort of 261 per group). Trevo use was not associated with a favorable 90-day mRS shift (proportional odds ratio [OR] 1.10, 95% confidence interval [CI] 0.80–1.51). Trevo was associated with fewer passes (adjusted β=-0.25, 95% CI −0.48 - −0.03), higher odds of TICI 2b-3 (adjusted OR 1.97, 95% CI 1.11–3.49), and a greater 24h NIHSS improvement (adjusted β= −1.74, 95% CI −3.11 - −0.36), with no difference in sICH or mortality (p>0.05). Results were similar in sensitivity analyses. Conclusions We observed no safety concerns with Trevo as compared to other EVT devices for DMVO recanalization. There was a signal of better technical efficacy and early clinical improvement.