Tenzing Assisted Delivery of Aspiration (TADA) technique for thrombectomy of medium vessel occlusions using the Freeclimb 54 catheter: multicenter experience
Open Access
- 23 January 2025
- journal article
- research article
- Published by BMJ in Journal of NeuroInterventional Surgery
- Vol. 17 (e2) , e197-e205
Abstract
Background Medium vessel occlusions (MeVOs) account for 25–40% of acute ischemic stroke. The Tenzing 5 (Route 92 Medical, San Mateo, California, USA) and FreeClimb 54 (Route 92 Medical, San Mateo, California, USA) catheter is a novel delivery–aspiration catheter combination designed to facilitate aspiration thrombectomy (AT) of MeVOs. We report our clinical experience using the Tenzing assisted delivery of aspiration (TADA) technique with FreeClimb 54 for first-line AT of MeVO. Methods We retrospectively reviewed consecutive patients who underwent MeVO first-line AT using TADA with FreeClimb 54 at nine institutions in the USA and one in New Zealand. Results 94 MeVOs (65 primary, 29 secondary) were treated in 92 patients: median age 71 (IQR 58–81) years; 49/92 (53%) women. FreeClimb 54 was successfully delivered by Tenzing 5 to all 94/94 MeVOs: 26 proximal M2; 44 distal M2; 5 M3; 6 A2; 4 A3; and 8 P2. Median target vessel diameter on DSA was 1.7 (IQR 1.4–1.8) mm. A leading microwire was used to advance Tenzing in 84% of cases. A stent retriever was used for additional thrombectomy passes in 6/94 (6%) patients. For a primary MeVO, final modified expanded Thrombolysis in Cerebral Infarction (meTICI) 2B–3 reperfusion was achieved in 63/65 (97%) patients, after a median of 1 (IQR 1–2) pass, with a first pass effect (FPE, meTICI 2C–3) in 43/65 (66%). Secondary MeVO FPE (eTICI 2C–3) was achieved in 20/29 (69%) patients. Tenzing 5–FreeClimb 54 related complications occurred in 2/94 (2%) patients: one perforation with asymptomatic subarachnoid hemorrhage and one embolus to new territory. Conclusions MeVO first-line AT using the TADA technique with Tenzing 5 and FreeClimb 54 had a high FPE with a low complication rate.Keywords
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