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Knapen RRMM, Simon SR, Robbe MMQ, Jongkind J, Brans R, de Ridder IR, van Oostenbrugge RJ, van Zwam WH, van der Leij C. Comparison of clinical, technical, and safety outcomes between the Sofia 5Fr catheter vs. the Sofia 6Fr catheter; a MaSQ-Registry study. J Stroke Cerebrovasc Dis 2024; 33:107967. [PMID: 39187212 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 08/21/2024] [Accepted: 08/22/2024] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND Direct aspiration during endovascular treatment (EVT) for acute ischemic stroke (AIS) patients is safe and effective. The 'Soft torqueable catheter Optimized For Intracranial Access' (Sofia) catheter is commonly used. Data on differences between 5Fr and 6Fr Sofia is limited. Hence, we aimed to compare the clinical, technical, and safety outcomes between both Sofia catheters in AIS patients. METHODS Patients with an intracranial anterior circulation occlusion from the 'Maastricht Stroke Quality-registry' (MaSQ-registry), who underwent EVT for AIS from September 2020 to February 2023, and treated with the Sofia catheter in the first-line technique were included. Outcomes included a shift on the modified Rankin Scale (mRS) score at 90 days, favorable functional outcome (mRS 0-2), first-attempt recanalization rate, and per procedural complications. Multivariable regression analyses were performed with adjustments. RESULTS Out of 511 registered patients in the MaSQ-registry, 366 patients were included. 281 patients (77 %) were treated with the Sofia 6Fr. No shift towards better outcomes on the ordinal mRS score at 90 days was observed in the Sofia 6Fr group compared to the 5Fr (adjusted common[ac] OR:1.34, 95 %CI:0.70-2.56). Favorable functional outcome (aOR:1.24, 95 %CI:0.49-3.13), and per procedural complications (aOR:1.04, 95 %CI:0.41-2.64) did not differ significantly between Sofia 6Fr and 5Fr. The Sofia 6Fr achieved higher first-attempt successful recanalization rates (53 % versus 34 %; aOR:2.28, 95 %CI:1.11-4.69), and lower total thrombectomy attempts (median:1 versus 2; aβ:-0.63, 95 %CI:-1.21 to -0.05). CONCLUSIONS The use of 6Fr Sofia aspiration catheter leads in this single-center registry to higher first-attempt successful recanalization rates and fewer thrombectomy attempts compared to the 5Fr Sofia catheter. However, this did not reflect in better clinical outcomes.
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Affiliation(s)
- R R M M Knapen
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+ and School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, the Netherlands.
| | - S R Simon
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands.
| | - M M Q Robbe
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+ and School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, the Netherlands.
| | - J Jongkind
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands.
| | - R Brans
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands.
| | - I R de Ridder
- Department of Neurology, Maastricht University Medical Center+ and School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, the Netherlands.
| | - R J van Oostenbrugge
- Department of Neurology, Maastricht University Medical Center+ and School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, the Netherlands.
| | - W H van Zwam
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+ and School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, the Netherlands.
| | - C van der Leij
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands.
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Essibayi MA, Brinjikji W. Efficacy and safety of SOFIA aspiration catheter for mechanical thrombectomy via ADAPT and Solumbra echniques in acute ischemic stroke: A systematic review and meta-analysis. Interv Neuroradiol 2024; 30:326-335. [PMID: 35695222 PMCID: PMC11310730 DOI: 10.1177/15910199221107438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/15/2022] [Accepted: 05/29/2022] [Indexed: 10/18/2022] Open
Abstract
INTRODUCTION SOFIA catheter is a relatively new and recently FDA-approved aspiration catheter. This systematic review aims to investigate the safety and efficacy of SOFIA catheter for treatment of acute ischemic stroke (AIS) via ADAPT and Solumbra techniques. METHODS Search of all studies evaluating the SOFIA catheter for mechanical thrombectomy (MT) for treatment of AIS via ADAPT and Solumbra techniques from inception through 2020 on Pubmed, PMC, and Embase was performed. We analyzed the angiographic and clinical outcomes of both techniques with SOFIA catheter using the random-effects model. RESULTS From 18 studies, 1836 patients were included with 1365 receiving MT using ADAPT and 471 with solumbra technique. The mean age was 69.8 years and 51.1% of the patients were women. The rate of rescue therapy was 30%. The outcomes rates of ADAPT group were as follows; mFPE (59.3%), FPE (34.4%) final TICI 2b/3 (89.3%), procedural complications (8%), embolization to new territory (ENT) (2.3%), symptomatic ICH (5.4%), mean NIHSS (8.97), 90-day-mRS 0-2 (48.8%), and mortality (15.3%). The outcomes rates of Solumbra group were as follows; mFPE (60.5%), FPE (46.7%), final TICI 2b/3 (93%), procedural complications (6.4%), ENT (2%), symptomatic ICH (6%), mean NIHSS (7.59), mRS 0-2 (53.8%), and mortality (10.8%). ICA and posterior circulation strokes, and tandem lesions had worse outcomes (P < .005). MCA strokes were associated with better outcomes (P = .005). ASPECT scores' association with the clinical outcomes was found statistically significant. CONCLUSION SOFIA catheter is effective and safe to treat acute ischemic stroke regardless of applied MT technique.
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Affiliation(s)
| | - Waleed Brinjikji
- Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
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Gao W, Qin B, Qin H, Qin C, Zhang J, Liang Y, Qin C. Efficacy and Safety of the Soft Torqueable Catheter Optimized For Intracranial Access in the Endovascular Treatment of Acute Ischemic Stroke: A Meta-Analysis. World Neurosurg 2023; 171:167-174.e7. [PMID: 36526223 DOI: 10.1016/j.wneu.2022.12.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Acute ischemic stroke (AIS) is a severe, life-threatening type of stroke with poor prognosis and high recurrence rate, mainly attributed to large vessel occlusion (LVO). Improved understanding of the safety and effectiveness of the Soft Torqueable Catheter Optimized For Intracranial Access (SOFIA) for LVO-AIS might guide practitioners. Therefore, we conducted this study focusing on neurological outcomes, procedure-related complications, and recanalization rates. METHODS We collected data in January 2022 from PubMed, Cochrane, Web of Science, and Embase. The study considered that assessed the effects of the SOFIA catheter in treatment of LVO-AIS. We extracted data narratively and expressed the results with the proportions and 95% confidence intervals (CI). RESULTS We included 17 studies reporting on 2106 patients treated with the SOFIA catheter. The successful recanalization rate was 77% (95% CI, 71%-83%) with the SOFIA catheter alone and the application of a rescue stent-retriever was observed in 28% (95% CI, 23%-33%) of cases, resulting in an overall successful recanalization rate of 90% (95% CI, 87%-92%). A pooled estimate of 45% (95% CI, 39%-51%) was observed for functional independence at 90 days, 15% (95% CI, 11%-20%) for mortality at 90 days, and 5% (95% CI, 3%-8%) for symptomatic intracranial hemorrhage. CONCLUSIONS This meta-analysis revealed that aspiration thrombectomy with the SOFIA catheter is a safer and effective treatment modality for LVO-AIS.
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Affiliation(s)
- Wen Gao
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China; Department of Neurology, Liuzhou People's Hospital Affiliated to Guangi Medical University, Liuzhou, Guangxi, China
| | - Bin Qin
- Department of Neurology, Liuzhou People's Hospital Affiliated to Guangi Medical University, Liuzhou, Guangxi, China
| | - Huixun Qin
- Department of Neurology, Liuzhou People's Hospital Affiliated to Guangi Medical University, Liuzhou, Guangxi, China
| | - Cheng Qin
- Department of Neurology, Liuzhou People's Hospital Affiliated to Guangi Medical University, Liuzhou, Guangxi, China
| | - Jiede Zhang
- Department of Neurology, Liuzhou People's Hospital Affiliated to Guangi Medical University, Liuzhou, Guangxi, China
| | - Yumin Liang
- Department of Neurology, Liuzhou People's Hospital Affiliated to Guangi Medical University, Liuzhou, Guangxi, China
| | - Chao Qin
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
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Brinjikji W, Raz E, De Leacy R, Meila D, Mokin M, Samaniego EA, Shapiro M, Bageac D, Varon A, Ren Z, Rinaldo L, Cloft HJ. MRS SOFIA: a multicenter retrospective study for use of Sofia for revascularization of acute ischemic stroke. J Neurointerv Surg 2021; 14:neurintsurg-2020-017042. [PMID: 33526479 DOI: 10.1136/neurintsurg-2020-017042] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/24/2020] [Accepted: 01/05/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND Over the past several years there has been increased interest in the use of the Sofia aspiration system (MicroVention, Tustin, California) as a primary aspiration catheter. OBJECTIVE To perform a multicenter retrospective study examining the efficacy of the Sofia aspiration catheter as a standalone aspiration treatment for large vessel occlusion. METHODS Consecutive cases in which the Sofia catheter was used for aspiration thrombectomy for large vessel occlusion were included. Exclusion criteria were the following: (1) Sofia not used for first pass, and (2) a stent retriever used as an adjunct on the first pass. The primary outcome of the study was first pass recanalization (Thrombolysis in Cerebral Infarction (TICI) 2c/3). Secondary outcomes included first pass TICI 2b/3, crossover to other thrombectomy devices, number of passes, time from puncture to recanalization, and complications. RESULTS 323 patients were included. First pass TICI 2c/3 was achieved in 49.8% of cases (161/323). First pass TICI 2b/3 was achieved in 69.7% (225/323) of cases. 74.8% had TICI 2b/3 with the Sofia alone. Crossover to other thrombectomy devices occurred in 29.1% of cases (94/323). The median number of passes was 1 (IQR=1-3). Median time from puncture to recanalization was 26 min (IQR=17-45). Procedure related complications occurred in 3.1% (10/323) of cases. CONCLUSION Our study highlights the potential advantage of the Sofia aspiration catheter for primary aspiration thrombectomy in acute ischemic stroke. High rates of first pass recanalization with low crossover rates to other thrombectomy devices were achieved. Median procedure time was low, as were procedural complications.
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Affiliation(s)
| | - Eytan Raz
- Department of Radiology, NYU, New York, New York, USA
| | - Reade De Leacy
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Dan Meila
- Department of Radiology and Neuroradiology, Klinikum Duisburg - Sana Kliniken, Duisburg, Germany
| | - Maxim Mokin
- Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, Florida, USA
| | - Edgar A Samaniego
- Interventional Neuroradiology/Endovascular Neurosurgery Division Department of Neurology, Neurosurgery and Radiology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Maksim Shapiro
- Department of Interventional Radiology, New York University Langone Medical Center, New York, New York, USA
| | - Devin Bageac
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Alberto Varon
- Interventional Neuroradiology/Endovascular Neurosurgery Division Department of Neurology, Neurosurgery and Radiology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Zeguang Ren
- Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, Florida, USA
| | - Lorenzo Rinaldo
- Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Harry J Cloft
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
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