Efficacy Assessment of the TIMSO Microcatheter for Endovascular Thrombectomy in the Treatment of Acute Ischemic Stroke

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BACKGROUND: Endovascular thrombectomy is an effective treatment for acute ischemic stroke, and accurate determination of thrombus length (TL) remains pivotal to successful endovascular thrombectomy. However, to date, no modality could estimate the TL with sufficient efficiency, especially in the emergent setting. In the current study, we presented a novel microcatheter design known as the Tip-End Multi-Side Orifices (TIMSO) microcatheter, which could provide real-time TL assessment. METHODS: The efficacy of the TIMSO was initially validated in an endovascular simulator with continuous saline circulation. After the TIMSO passed the sham thrombus, colored saline was injected through the TIMSO. The length of the ink defect region was integrated with the sham TL. Subsequently, in the live swine acute ischemic stroke model, the efficacy of TIMSO was further evaluated under digital subtraction angiography. RESULTS: <0.01). In the in vivo test, the TIMSO could also demonstrate TL (n=10). Interestingly, the TIMSO also detected tandem thrombi, newly formed emboli associated with thrombus fragmentation, and the precise arterial branches towards which the thrombi tend to migrate at arterial bifurcations. CONCLUSIONS: Conclusively, the TIMSO microcatheter could facilitate real-time assessment of TL during endovascular thrombectomy. Furthermore, TISMO has the capacity to discern special embolization scenarios. These characteristics of TIMSO have the potential to contribute to the facilitation of endovascular thrombectomy in future clinical practice.

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