P-027 Ultra-early functional improvement after stroke thrombectomy – predictors and implications

S Desai, D Tonetti, G Nayar, A Morrison, K Shah, T Jovin, A Jadhav
2021 Oral poster abstracts   unpublished
cytotoxicity of organic solvents (e.g., Dimethyl Sulfoxide (DMSO)). Aqua Embolic System (AES) is a new LEM, which is mainly composed of multiple polysaccharides. AES, when injected via a microcatheter, immediately forms a solid and elastic hydrogel cast upon exposure to Ca2+ in the bloodstream. The use of organic solvents, e.g., DMSO, is not required. The performance of AES was evaluated using an established AVM model utilizing swine rete-mirabile. Methods Under general anesthesia, the left
more » ... nding pharyngeal artery (APA) of Yorkshire swine (40 kg) was catheterized using a microcatheter (ID:0.013 inches), and AES was slowly injected into the rete-mirabile under fluoroscopy. The following parameters were assessed to evaluate the embolization performance of the AES; 1) the amount of AES required for the complete occlusion of the feeding artery, 2) injection speed, 3) radiopacity during the deployment, and 4) incidence of catheter entrapment after the injection. The same evaluation was performed on the contralateral rete-mirabile and the left renal artery as well. Results 12 arteries in 4 swine were treated, and all arteries were completely occluded without technical complications. The injected materials immediately formed AES cast in all vessels, followed by the reflux over the tip of the microcatheter. All catheters were withdrawn without any sign of catheter entrapment. The AES mixed with tantalum-based contrasts medium showed sufficient radiopacity under fluoroscopy. With the injection speed of 0.02ml/sec, the average volume required was 0.85mL for the APA and 2.9mL for the renal artery. No increased thrombogenicity or vasospasm near the treated lesion was observed during the procedure. Conclusions AES, which is a DMSO free, non-adhesive polysaccharides based LEM, may be used as an embolic material for the treatment of hemorrhagic stroke caused by cerebrovascular diseases, such as brain AVM. A: common carotid artery injection (AP view) shows left ascending pharyngeal artery (APA) and left rete mirabile (red arrow). B: AES is injected from the microcatheter. The AES reflux is reaching the tip of the microcatheter. C: With continuous injection of AES, the microcotheter tip is embedded ¡n the cost of AES. D. Post treatment angiogram shows complete occlusion of the left rete mirabile and APA Disclosures I. Yuki:
doi:10.1136/neurintsurg-2021-snis.63 fatcat:impk4lblqzcqboi5qzdxm6roha