• Lukas Goertz, Daniel Weiss, Nuran Abdullayev, Christoph Moenninghoff, Jan Borggrefe, Timo Huan Phung, Patrick Haage, Marc Schlamann, Franziska Dorn, Marius Kaschner, Christoph Kabbasch, and Hannes Nordmeyer.
• Department of Neuroradiology, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany. Electronic address: lukas.goertz@uk-koeln.de.
• World Neurosurg. 2022 Nov 1; 167: e386e396e386-e396.

ObjectiveTo report our initial experience with the novel low-profile APERIO Hybrid17 Thrombectomy Device (AP17) for proximal and distal vessel occlusions in acute ischemic stroke.MethodsA multicentric retrospective analysis of patients treated with the AP17 was performed. The primary effectiveness endpoint was first-pass TICI ≥2b (Thrombolysis in cerebral infarction scale). The primary safety endpoint was the occurrence of hemorrhagic complications. Further outcome measures were number of passes, device-related complications, and 3-month functional outcome.ResultsThe AP17 was used in 71 patients (mean age: 73 years) with a median baseline National Institutes of Health Stroke Scale score of 9. Treated vessels were the carotid-T in 8 cases (11%), the M1-segment in 16 (23%), the M2-segment in 29 (41%), the anterior cerebral artery in 3 (4%), and basilar/posterior cerebral arteries in 15 (21%). The rates of first-pass and final TICI ≥2b were 75.6% and 92.7%, retrospectively, with a mean number of passes of 3 ± 2. Final TICI ≥2b rates were comparable between large and medium vessel occlusions. Symptomatic intracranial hemorrhages were recorded in 2 cases (2.8%). At 3-month clinical follow-up, a modified Rankin scale score ≤2 was achieved in 69.0% (29/42). The all-cause mortality at discharge was 17.4%.ConclusionsThe AP17 was associated with a reasonable safety and efficacy profile for both proximal and distal vessel occlusions. These results may contribute to establish mechanical thrombectomy for distal occlusions.Copyright © 2022 Elsevier Inc. All rights reserved.

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