title: Multicenter experience with the new SOFIA Plus catheter as a primary local aspiration catheter for acute stroke thrombectomy.
abstract: BACKGROUND
  The direct aspiration first pass technique (ADAPT) has been introduced as a rapid and safe endovascular treatment strategy in patients with ischemic stroke.
  
  
  OBJECTIVE
  To determine the technical feasibility, safety, and functional outcome with ADAPT using the new large-bore 6F SOFIA Plus catheter.
  
  
  METHODS
  A retrospective analysis of prospectively collected data from six university hospitals was performed. The following parameters of all acute stroke procedures (June 2015- January 2016) using the SOFIA Plus catheter were analyzed: accessibility of the thrombus with the catheter, recanalization success (Thrombolysis in Cerebral Infarction ≥2b), time to recanalization, procedure-related complications. Furthermore, National Institutes of Health Stroke Scale (NIHSS) scores at presentation and discharge and the modified Rankin scale (mRS) score at 90 days were recorded.
  
  
  RESULTS
  85 patients were treated using the SOFIA Plus catheter. The occlusion site was the anterior circulation in 94.1%. Median baseline NIHSS score was 18. In 64.7%, ADAPT alone was successful after a median procedure time of 21 min. With additional use of stent retrievers in the remaining cases, the recanalization rate was 96.5%. No catheter-related complications such as dissections were observed. Thrombus migration to a new vascular territory occurred in 4.7% and symptomatic hemorrhage in 4.7%. After 3 months, mRS 0-2 was achieved in 49.4%. Mortality rate was 20%.
  
  
  CONCLUSIONS
  In the majority of cases, thrombus aspiration using the SOFIA Plus catheter results in successful recanalization after a short procedure time. With additional use of stent retrievers, a high recanalization rate can be achieved (96.5%). The complication rate was in line with those of previous publications.
authors.affiliation: Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
authors.forename: M A
authors.initials: MA
authors.lastname: Möhlenbruch
authors.affiliation: Department of Radiology and Neuroradiology, University Hospital of Cologne, Cologne, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Kabbasch
authors.affiliation: Department of Radiology and Neuroradiology, University Medical Center Langendreer, Ruhr-University-Bochum, Bochum, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Kowoll
authors.affiliation: Department of Neurology/Research Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria.
authors.forename: E
authors.initials: E
authors.lastname: Broussalis
authors.affiliation: Department of Neuroradiology, Kepler University Hospital, Linz, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Sonnberger
authors.affiliation: Department of Diagnostic and Interventional Neuroradiology, RWTH Aachen University, Aachen, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Müller
authors.affiliation: Department of Diagnostic and Interventional Neuroradiology, RWTH Aachen University, Aachen, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Wiesmann
authors.affiliation: Department of Neuroradiology, Kepler University Hospital, Linz, Austria.
authors.forename: J
authors.initials: J
authors.lastname: Trenkler
authors.affiliation: Department of Neurology/Research Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Killer-Oberpfalzer
authors.affiliation: Department of Radiology and Neuroradiology, University Medical Center Langendreer, Ruhr-University-Bochum, Bochum, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Weber
authors.affiliation: Department of Radiology and Neuroradiology, University Hospital of Cologne, Cologne, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Mpotsaris
authors.affiliation: Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Bendszus
authors.affiliation: Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Stampfl
mesh_terms: D000328:Adult; D000368:Aged; D002545:Brain Ischemia / Q000000981:diagnostic imaging* / Q000601:surgery*; D057785:Catheters / Q000009:adverse effects; D005260:Female; D006801:Humans; D008875:Middle Aged; D010351:Patient Discharge / Q000639:trends; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D011446:Prospective Studies; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects; D020521:Stroke / Q000000981:diagnostic imaging* / Q000601:surgery*; D017131:Thrombectomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome
keywords: Catheter; Intervention; Stroke; Thrombectomy