• Tomotaka Ohshima, Kojiro Ishikawa, Shunsaku Goto, and Taiki Yamamoto.
• Department of Neurosurgery, Kariya Toyota General Hospital, Kariya, Japan. Electronic address: tmtkoh@gmail.com.
• World Neurosurg. 2017 Nov 1; 107: 657-662.

BackgroundAlthough endovascular approaches for acute ischemic stroke have been developed, the appropriate selection and sequence of device application or other treatments is unclear. If information about the clot quality can be obtained before the selection of devices, fast recanalization with a suitable device and strategy can be achieved. We studied the relationship between clot quality and the configuration of a microguidewire during endovascular thrombectomy.MethodsThis prospective single-center study included all patients who were admitted for acute ischemic stroke between October 2015 and June 2017 and underwent emergency endovascular thrombectomy. We used a modified pigtail-shaped microguidewire to penetrate clots. The configurations under radiograph were distinguished into 2 types and assessed according to collected clot appearance and quality.ResultsA total of 54 patients underwent acute endovascular thrombectomy. When the tip of the microguidewire became stuck against a clot during penetration, the clot was solid and hard, with statistical significance (P = 0.013).ConclusionsOur results showed that we can select a suitable device and strategy for fast recanalization according to information about clot quality obtained using the modified pigtail-shaped microguidewire.Copyright © 2017 Elsevier Inc. All rights reserved.

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