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. 2025 Apr 11:jnis-2025-023096.
doi: 10.1136/jnis-2025-023096. Online ahead of print.

Super-large bore catheter in the treatment of large vessel occlusions: initial multicenter experience

Edgar A Samaniego  1 , Andres Gudino  2 , Leonardo Cruz-Criollo  2 , Carlos Dier  2 , Brian T Jankowitz  3 , Aishwarya Aggarwal  4 , Haralabos Zacharatos  4 , Alhamza R Al-Bayati  5 , Raul Nogueira  5 , Mohamed F Doheim  6 , Shahram Majidi  7 , Michael T Froehler  8 , Mir Amaan Ali  8 , Ramesh Grandhi  9 , Santiago Gomez-Paz  9 , Jaydevsinh Dolia  10 , Jonathan A Grossberg  11 , Vinay Jaikumar  12 , Adnan Siddiqui  12 , Ajit S Puri  13 , Raymond Catton  13 , Jasmeet Singh  13 , Sohyun Boo  14 , Mohamad Ezzeldin  15   16 , Santiago Ortega-Gutierrez  2 , Fawaz Al-Mufti  17
Affiliations

Super-large bore catheter in the treatment of large vessel occlusions: initial multicenter experience

Edgar A Samaniego et al. J Neurointerv Surg. .

Abstract

Purpose: Large bore catheters are increasingly used in mechanical thrombectomy (MT) for large vessel occlusions (LVOs).

Objective: To evaluate the efficacy and safety of the super-large bore Cereglide 0.092" (C-92) catheter, featuring the largest inner diameter available.

Methods: A multicenter observational study was conducted across 12 comprehensive stroke centers in the United States. Efficacy outcomes included the first pass effect (FPE) and successful reperfusion. FPE was defined as a first MT pass achieving a modified Treatment in Cerebral Infarction (mTICI) score of ≥2c. Successful reperfusion was defined as final mTICI score ≥2c. Safety outcomes involved device-related complications, symptomatic intracranial hemorrhage (sICH), and inpatient mortality. Functional outcomes included modified Rankin Scale (mRS) score at discharge and delta National Institutes of Health Stroke Scale (NIHSS) score.

Results: Fifty patients were included. The most common LVO was the first segment of the middle cerebral artery in 31/50 cases (62%). The C-92 reached the thrombus in 41 patients (82%). Median puncture-to-thrombus and puncture-to-reperfusion times were 15 min (IQR 10-25) and 26 min (IQR 15-49), respectively. FPE was achieved in 25/50 (50%) cases, and in 25/41 (61%) cases when the C-92 reached the thrombus. Successful reperfusion occurred in 36/41 patients (88%). There were no vessel perforations, or sICH. Distal embolization occurred in 4/50 (8%) cases, and 4/50 (8%) died. The mRS score at discharge was 3 (IQR 2-6), and the delta NIHSS score was 8 (IQR 5-12).

Conclusion: The C-92 catheter demonstrated a safe profile achieving an overall FPE rate of 50%, and favorable functional outcomes in 88% of cases.

Keywords: Catheter; Stroke; Thrombectomy.

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Conflict of interest statement

Competing interests: EAS: Consultant for MicroVention, Medtronic, Rapid Medical, iSchemaview, and Cerenovus-Johnson and Johnson. AG, LG-C, CD, AA, HZ, RN, MFD, MAA, SG-P, JAG, VJ, ASP, RC, JS, and FA-M: Report no disclosures. BTJ: Consultant for Medtronic, Stryker, Rapid Medical, Cerenovus-Johnson and Johnson, Balt. ARA-B: Consultant for Cerenovus-Johnson and Johnson and Stryker Neurovascular. SM: Consultant for Cerenovus-Johnson and Johnson. MTF: Consultant to Balt, Cerenovus-Johnson and Johnson, Siemens, Medtronic, TG Medical, Jacobs Institute; on DSMB/CEC for Balt, Imperative, Galaxy Therapeutics. RG: Consultant for Balt, Cerenovus-Johnson and Johnson, Stryker Neurovascular, Medtronic Neurovascular, Rapid Medical. JD: Consultant for Cerenovus-Johnson and Johnson. AS: Consultant/Advisory Board: Asahi Intecc Co. Ltd., Canon Medical Systems USA, Inc., CerebrovaKP, Cerenovus-Johnson and Johnson, Contego Medical, Inc., Cordis, Endostream Medical, Ltd, FreeOx Biotech, SL, Hyperfine Operations, Inc., Imperative Care, InspireMD, Ltd., IRRAS AB, Medtronic, MicroVention (now Terumo Neuro), Minnetronix Neuro, Inc., Peijia Medical, Perflow Medical, Ltd., Piraeus Medical, Inc., Prometheus Therapeutics, Inc., Q’Apel Medical, Inc., Serenity Medical, Inc., Shockwave Medical, Inc., StimMed, LLC, Stryker Neurovascular., Synchron Australia Pty Ltd., T.G. Medical, Inc., Vastrax, LLC, Vesalio, Viz.ai, Inc., WL Gore. SB: Consultant for Cerenovus-Johnson and Johnson, Stryker and Microvention. ME: Consultant Stryker, Imperative Care and Viz.ai. SO-G: Medtronic, Stryker Neurovascular, MicroVention.

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