Turkish Neurosurgery
Endovascular Stroke Therapy Focused on Direct Clot Aspiration Using Sofia Catheter in Acute Ischemic Stroke
İlkay Akmangit1, Bige Sayin1, Ayberk Karaman2, Ergün Daglioglu2, Berna Arli3, Mustafa Harun Sahin3, Gurdal Orhan3
1Ankara Şehir Hastanesi, Radyoloji, Ankara,
2Ankara Şehir Hastanesi, Nöroşirurji, Ankara,
3Ankara Şehir Hastanesi, Nöroloji, Ankara,
DOI: 10.5137/1019-5149.JTN.34409-21.3

Aim:In the recent years, mechanical thrombectomy has been the standard of care for large vessel occlusions in patients with acute ischemic stroke. It can be achieved by contact aspiration using a direct aspiration first pass technique (ADAPT), a preferred method for endovascular treatment. Although the recently developed SOFIA catheter has been widely used for thrombo aspiration by interventionalists, there is limited evidence on its on safety and efficacy. Herein, we report our experience of mechanical thrombectomy using the SOFIA catheter, in terms of its effectivenessicacy and safety. Material and Methods:Acute ischemic stroke patients with large vessel occlusions who underwent mechanical thrombectomy, with the SOFIA aspiration catheter as the first-line approach, were retrospectively identified. For all patients, the data, including reperfusion success (modified Thrombolysis in Cerebral Infarction [mTICI]), procedural details, clinical status at the baseline and post-discharge at 90 days, and complications, were analysed. Results:During the study period (January 2017–July 2020), 73 patients underwent endovascular thrombectomy. The mean age and the baseline National Institutes of Health Stroke scores were 72 (41–83) and 16 (12–25), respectively. Successful reperfusion (mTICI≥2b–3) was obtained in 80.8 % (n=59) of the patients. Using ADAPT, a first-pass effect was achieved in 63.01% (n=46) of the patients. Rescue stent retriever (SRV) had to be utilized in 36.98% (n=27) of the patients; all presented with a favourable clinical outcome (modified Rankin score ≤0-2) at 90 days. The complication rate in the study was 13.7% (n=10). Conclusion:The Contact aspiration approach with SOFIA catheters as a first-line device appears to be fast, safe, and effective. Our results were comparable to the findings of other series. In the case of insufficient response on contact aspiration, we could easily modify the SOFIA catheter approach for an additional stent retriever rescue treatment.

Corresponding author : İlkay Akmangit