VacLok-Augmented Direct Aspiration Thrombectomy

Excerpt

Mechanical thrombectomy using direct aspiration and/or stent retrievers has become the standard of care for acute ischemic stroke secondary to large vessel occlusions, with complete reperfusion (thrombolysis in cerebral infarction 2c-3) at first pass being a key metric of successful thrombectomy [1]. An aspiration first-pass approach to mechanical thrombectomy is sometimes favored as it achieves a similar rate of final successful reperfusion and good functional outcome, while conferring shorter groin-to-reperfusion times and lower total device costs when compared to a stent-retriever-first approach [2]; however, direct aspiration can fail to achieve recanalization in 32% of cases and generally results in a higher rate of needinga rescue device [3], risking clot disruption and distal embolization with multiple attempts at thrombectomy [4]. In this case report we present a case of successful mechanical thrombectomy utilizing a 50 ml VacLok syringe to augment the vacuum pressure of the aspiration pump following two unsuccessful attempts at first-pass direct aspiration thrombectomy. …