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Title: E-106 Feasibility of automation of staged balloon guide catheter (BGC) aspiration during stroke thrombectomy using a customizable Ipad app and a bluetooth-enabled smart pump: an in-vitro study
Purpose: Multiple studies suggest that addition of cervical balloon guide catheter (BGC) aspiration to intracranial suction aspiration or thrombectomy improves outcomes (1). Currently, stroke thrombectomy when performed with cervical BGC/Guide catheter (GC) aspiration requires two (2) operators. Utilizing an automated smart pump could enable a single (1) operator to perform BGC-assisted thrombectomy while varying the suction intensity in different segments of the intracranial and cervical vasculature. Methods: Phase 1: Staged BGC aspiration (initially low, medium, then high - to avoid vessel collapse) is manually performed using a 60cc syringe and a 9F BGC. The suction intensity levels for low, medium, and high (in inHg) are measured using a vacuum gauge (2). Phase 2: the Mean suction levels and duration from three sample measurements are entered into an iPad app (CLEARTM Pro, Insera Therapeutics, Inc.) to create a suction pattern. Phase 3: With a BGC positioned in an in-vitro flow model simulating stroke thrombectomy, the feasibility of automated staged BGC aspiration is assessed. The iPad app activates a bluetooth-enabled smart pump (CLEARTM Aspiration System, Insera Therapeutics, Inc.) connected to the BGC. Results: Phase 1 testing was performed. Low suction ranged from 10-13 inHg (Mean: 12 inHg) with a duration ranging from 11-17s (Mean: more » 13s), Medium suction ranged from 15-18 inHg (Mean: 16 inHg) with a duration ranging from 8-11s (Mean: 9s), High suction ranged from 24-26 inHg (Mean: 25 inHg) with a duration ranging from 19-25s (Mean: 22s), The total duration of staged BGC aspiration ranged from 39-53s with a 60s safety pause or end of suction prior to another retrieval attempt. Phases 2 & 3 were successfully performed to create a customized BGC pattern and staged BGC aspiration was automated during simulated stroke thrombectomy. Conclusions: Automated staged BGC or GC aspiration is feasible using a customizable iPad app and a bluetooth-enabled smart pump. Funding Source: This study was funded in part by a research grant (NSF Award: 1819491; PI: Vallabh Janardhan, MD) from the National Science Foundation (NSF). Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of the National Science Foundation. Conference Proceeding: This paper was presented in part at the 15th Annual Meeting of the Society of Neuro-Interventional Surgery (SNIS), July 23-26, 2018 in San Francisco, CA. « less
Authors:
; ;
Award ID(s):
1819491
Publication Date:
NSF-PAR ID:
10132843
Journal Name:
Journal of neurointerventional surgery
Volume:
10
Issue:
2
Page Range or eLocation-ID:
A100-A101
ISSN:
1759-8478
Sponsoring Org:
National Science Foundation
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  1. Multiple studies suggest that addition of cervical balloon guide catheter (BGC) aspiration to intracranial suction aspiration or thrombectomy improves outcomes (1). Currently, stroke thrombectomy when performed with cervical BGC/Guide catheter (GC) aspiration requires two (2) operators. Utilizing an automated smart pump could enable a single (1) operator to perform BGC-assisted thrombectomy while varying the suction intensity in different segments of the intracranial and cervical vasculature. Phase 1: Staged BGC aspiration (initially low, medium, then high - to avoid vessel collapse) is manually performed using a 60cc syringe and a 9F BGC. The suction intensity levels for low, medium, and highmore »(in inHg) are measured using a vacuum gauge (2). Phase 2: the Mean suction levels and duration from three sample measurements are entered into an iPad app (CLEARTM Pro, Insera Therapeutics, Inc.) to create a suction pattern. Phase 3: With a BGC positioned in an in-vitro flow model simulating stroke thrombectomy, the feasibility of automated staged BGC aspiration is assessed. The iPad app activates a bluetooth-enabled smart pump (CLEARTM Aspiration System, Insera Therapeutics, Inc.) connected to the BGC. Phase 1 testing was performed. Low suction ranged from 10-13 inHg (Mean: 12 inHg) with a duration ranging from 11-17s (Mean: 13s), Medium suction ranged from 15-18 inHg (Mean: 16 inHg) with a duration ranging from 8-11s (Mean: 9s), High suction ranged from 24-26 inHg (Mean: 25 inHg) with a duration ranging from 19-25s (Mean: 22s), The total duration of staged BGC aspiration ranged from 39-53s with a 60s safety pause or end of suction prior to another retrieval attempt. Phases 2 & 3 were successfully performed to create a customized BGC pattern and staged BGC aspiration was automated during simulated stroke thrombectomy. Automated staged BGC or GC aspiration is feasible using a customizable iPad app and a bluetooth-enabled smart pump. Funding Source: This study was funded in part by a research grant (NSF Award: 1819491; PI: Vallabh Janardhan, MD) from the National Science Foundation (NSF). Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of the National Science Foundation. Conference Proceeding: This paper was presented in part at the 2018 Annual Meeting of the Society of Vascular & Interventional Neurology (SVIN), November 14-17, 2018 in San Diego, CA« less
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