A Modified Solumbra Technique Using Low Profile Aspiration Catheter for Medium Vessel Occlusion

Introduction: The widely used, isolated stent-retriever and contact aspiration technique for distal and medium vessel occlusions (DMVOs) carries a high risk for clot fragmentation, spasm, and distal migration. We report outcomes of novel solumbra technique by using a smaller profile aspiration catheter for DMVOs.

Method(s): We retrospectively analyzed data from our institute for distal and medium vessel occlusions who underwent mechanical thrombectomy using modified solumbra technique. The technique involves deploying a stent retriever through microcatheter and large bore aspiration catheter like ACE 68/ CAT5 catheter, followed by both microcatheter and aspiration removal and blind navigation of a correctly sized lower profile aspiration catheter over stent bare wire to “pinch” the primal end of the clot.

Result(s): Total 14 DMVOs were successfully treated in 13 patients with solumbra technique since January 2022. Final first pass mTICI 2c/3 recanalization was achieved in all 13 patients (100%). Three patients encountered intra-procedural complications. A total of 10 patients (76%) achieved good clinical outcome at 90 days.

Conclusion(s): We found that this solumbra technique for DMVOs significantly leads to enhanced first-pass recanalization with lesser risk of intimal injury, dissection. and secondary embolization.

Publication History

Article published online:
09 February 2023