Prowler select plus

All patients were treated in the neuro-angiography suites under general anesthesia and were therefore sedated and intubated irrespective of their clinical status at admission. The devices used to achieve recanalization were at the discretion of the operator. Procedures were performed via the right common femoral route as standard using a 6F sheath. A brachial access route was used in patients if femoral access was not successful. Balloon guide catheters were not used as standard due to the location of the occlusions in the posterior circulation. The standard guide catheters included 6F Guider Softip (Boston Scientific) and 5F Envoy (Cordis). The microcatheters used in mechanical thrombectomy were either RapidTransit or Prowler Select Plus (Cordis, now Cerenovus); Trevo pro 18 MC (Stryker) or Velocity (Penumbra), The standard microguidewires were Synchro2 0.014” (Stryker) or pORTAL (phenox). Navien A+ 0.058” ID (Medtronic) and SOFIA Plus 0.070” ID (Microvention) were used for aspiration thrombectomies. Mechanical thrombectomy was performed with Solitaire FR (Medtronic) or pRESET (phenox). The earliest cases in the subset (2008–2009) used pCRC (phenox) or BONnet (phenox)devices.
The procedure time was defined as groin puncture time to final angiographic run. The date of treatment was recorded to test for any longitudinal effect on the clinical outcome.

A 2.3F microcatheter (Prowler Select Plus, Cordis) was navigated over a 0.014 micro guidewire (Synchro, Stryker) across the occlusive thrombus. A Jrecan device (4 × 20) or a Trevo^TM device (4 × 20) was delivered through the microcatheter and deployed across the clot under fluoroscopy. Angiographies were performed immediately and 5 min later to check blood flow restoration after stent deployment. Then the device and microcatheter were slowly pulled back into the guiding catheter, while aspiration was performed via a 25-ml syringe. We repeated the procedure until modified treatment in cerebral ischemia (mTICI) score ≥2b was achieved or a maximum of three thrombectomy passes were reached. The number of retrieval attempts was recorded (12 (link)). A post-thrombectomy angiogram was obtained at 1 h to document recanalization and complications including perforation, vasospasm, and distal embolization.