Go with the Flow to Maximize Clot Ingestion

Introduction: Clot ingestion is associated with better FPE. Force and flow rate are frequently used to evaluate aspiration catheters but their role in clot ingestion is not understood. We sought to understand how flow rate impacts clot ingestion.

Method(s): A 50 Hz system containing a pressure and flow gauge was used to measure water flow at 37°C for 4F and 6F catheters. Data were recorded for one minute to calculate average flow rates. Clot ingestion times were calculated using standardized synthetic soft clots. The catheter tip was then placed in contact with the clot. After reaching maximum vacuum pressure, the flow switch was opened. Flow, pressure, and time for the clot to be aspirated from the catheter tip to the canister were calculated.

Result(s): The mean flow rates for Q6, SOFIA Plus, Q4, 4Max were 7.5, 5.8, 5.5, and 3.2 mL/s, respectively (p < 0.0001). The mean clot ingestion time for Q6 and SOFIA Plus was 20.6 and 152.3 second s, respectively (p < 0.0001). The mean clot ingestion time for Q4 and 4Max was 9.0 and 993.5 seconds, respectively (p < 0.0001).

Conclusion(s): Our study found that higher flow rates were associated with more rapid clot ingestion. Partial catheters such as the Q which provide for more rapid flow rates may improve clot ingestion clinically.

Publication History

Article published online:
09 February 2023