The Q and A-The MIVI Q Catheters for Aspiration Thrombectomy-Initial Experience from London

Background: Aspiration thrombectomy is a widely accepted treatment option for large vessel occlusion (LVO). The MIVI aspiration system has a novel design to maximize the lumen size. We present the results of our initial experience with this innovative aspiration thrombectomy system. Materials and Methods: Retrospectively, we reviewed our database to find all cases of LVO treated with the MIVI Q system (February 2019 and July 2020). In addition, we recorded the baseline demographics, NIHSS, ASPECT, mTICI scores, procedural time, complications, and 90 day mRS. Results: Herein, we identified 25 patients with an average age of 65.3 +/- 19.3 years (range 19-89), majority of whom were female (n = 14, 56%). The average NIHSS was 16.9 +/- 6.7 (range 6-30), and the average CT ASPECT was 7.9 +/- 1.4 (range 5-10). The most common clot location was the M1 segment of the MCA (n = 16, 64%). Four of the patients had tandem lesions (16%). The average clot length was 21.7 +/- 31 mm (range 2-130 mm). Of the 23 cases where the Q catheter reached the proximal clot face, mTICI >= 2b was achieved on the first pass in 11 cases (44%), and at the end of the 'Q aspiration' only the procedures with 16 patients achieved mTICI >= 2b recanalization (64%). Stent-retrievers were used in 13 cases (52%). At the end of the procedure, 24 patients (96%) achieved mTICI >= 2b with 18 patients (72%) achieving mTICI >= 2c. The average number of passes with the Q catheter, including when it was used for SOLUMBRA, was 2.1 +/- 2.2 (range 1-10). The mean procedure time was 69 +/- 32 mins (range 7-116 mins). No complications were associated with the MIVI Q. Conclusions: The MIVI aspiration system is a novel technology with regards to aspiration mechanical thrombectomy. The system is easy to use with early results comparable to other large-bore catheter systems. However, further studies are needed.