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<meta name="DC.Title" content="Under Pressure: Comparison of Aspiration Techniques for Endovascular Mechanical Thrombectomy" />
<meta name="DC.Identifier" content="10.3174/ajnr.A5605" />
<meta name="DC.Date" content="2018-05-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2018 by American Journal of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Blood flow should be interrupted during mechanical thrombectomy to prevent embolization of clot fragments. The purpose of our study was to provide a handy overview of the most common aspiration devices and to quantify their flow characteristics.

MATERIALS AND METHODS: We assessed volumetric flow rates generated by a 60-mL VacLok vacuum pressure syringe, a Pump MAX aspiration pump, and a Dominant Flex suction pump connected to the following: 1) an 8F long sheath, 2) an 8F balloon-guide catheter, 3) an ACE 64 distal aspiration catheter, and 4) an AXS Catalyst 6 Distal Access Catheter. We used a water/glycerol solution, which was kept at a constant temperature of 20°C (viscosity, 3.7 mPa · s).

RESULTS: Aspiration with the syringe and the Dominant Flex suction pump achieved the highest flows, whereas aspiration with the Pump MAX was significantly lower ( P &lt; .001). Resistors in the aspiration system (tubing, connectors, and so forth) restricted flows, especially when the resistance of the catheter was small (due to its large diameter) and the connected resistors became the predominant resistance ( P &lt; .001). The syringe achieved an average vacuum pressure of −90 kPa, and the resulting flow was constant during almost the entire procedure of filling the syringe.

CONCLUSIONS: Sixty-milliliter VacLok vacuum pressure syringes and the Dominant Flex suction pump achieved high and constant flows likely sufficient to reverse blood flow during thrombectomy with an 8F sheath or balloon-guide catheter in the ICA and modern distal aspiration catheters in the MCA. The Pump MAX aspiration pump is dedicated for use with distal aspiration catheters and is unlikely to reverse blood flow in the ICA and MCA without balloon protection." />
<meta name="DC.Contributor" content="O. Nikoubashman" />
<meta name="DC.Contributor" content="D. Wischer" />
<meta name="DC.Contributor" content="H.M. Hennemann" />
<meta name="DC.Contributor" content="M. Büsen" />
<meta name="DC.Contributor" content="C. Brockmann" />
<meta name="DC.Contributor" content="M. Wiesmann" />
<meta name="article:published_time" content="2018-05-01" />
<meta name="article:section" content="Interventional" />
<meta name="citation_title" content="Under Pressure: Comparison of Aspiration Techniques for Endovascular Mechanical Thrombectomy" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Blood flow should be interrupted during mechanical thrombectomy to prevent embolization of clot fragments. The purpose of our study was to provide a handy overview of the most common aspiration devices and to quantify their flow characteristics.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;We assessed volumetric flow rates generated by a 60-mL VacLok vacuum pressure syringe, a Pump MAX aspiration pump, and a Dominant Flex suction pump connected to the following: 1) an 8F long sheath, 2) an 8F balloon-guide catheter, 3) an ACE 64 distal aspiration catheter, and 4) an AXS Catalyst 6 Distal Access Catheter. We used a water/glycerol solution, which was kept at a constant temperature of 20°C (viscosity, 3.7 mPa · s).&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Aspiration with the syringe and the Dominant Flex suction pump achieved the highest flows, whereas aspiration with the Pump MAX was significantly lower (&lt;i&gt;P&lt;/i&gt; &amp;lt; .001). Resistors in the aspiration system (tubing, connectors, and so forth) restricted flows, especially when the resistance of the catheter was small (due to its large diameter) and the connected resistors became the predominant resistance (&lt;i&gt;P&lt;/i&gt; &amp;lt; .001). The syringe achieved an average vacuum pressure of −90 kPa, and the resulting flow was constant during almost the entire procedure of filling the syringe.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Sixty-milliliter VacLok vacuum pressure syringes and the Dominant Flex suction pump achieved high and constant flows likely sufficient to reverse blood flow during thrombectomy with an 8F sheath or balloon-guide catheter in the ICA and modern distal aspiration catheters in the MCA. The Pump MAX aspiration pump is dedicated for use with distal aspiration catheters and is unlikely to reverse blood flow in the ICA and MCA without balloon protection.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
<meta name="citation_publisher" content="American Journal of Neuroradiology" />
<meta name="citation_publication_date" content="2018/05/01" />
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<meta name="citation_issn" content="0195-6108" />
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<meta name="citation_doi" content="10.3174/ajnr.A5605" />
<meta name="citation_pmid" content="29650784" />
<meta name="citation_volume" content="39" />
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<meta name="citation_article_type" content="Research Article" />
<meta name="citation_section" content="Interventional" />
<meta name="citation_firstpage" content="905" />
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<meta name="citation_author" content="O. Nikoubashman" />
<meta name="citation_author_institution" content="aFrom the Department of Diagnostic and Interventional Neuroradiology (O.N., D.W., H.M.H., M.W.), RWTH Aachen University Hospital, Aachen, Germany" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-2055-4217" />
<meta name="citation_author" content="D. Wischer" />
<meta name="citation_author_institution" content="aFrom the Department of Diagnostic and Interventional Neuroradiology (O.N., D.W., H.M.H., M.W.), RWTH Aachen University Hospital, Aachen, Germany" />
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<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-9175-972X" />
<meta name="citation_author" content="M. Büsen" />
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<meta name="citation_author" content="C. Brockmann" />
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<meta name="twitter:title" content="Under Pressure: Comparison of Aspiration Techniques for Endovascular Mechanical Thrombectomy" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Blood flow should be interrupted during mechanical thrombectomy to prevent embolization of clot fragments. The purpose of our study was to provide a handy overview of the most common aspiration devices and to quantify their flow characteristics.

MATERIALS AND METHODS: We assessed volumetric flow rates generated by a 60-mL VacLok vacuum pressure syringe, a Pump MAX aspiration pump, and a Dominant Flex suction pump connected to the following: 1) an 8F long sheath, 2) an 8F balloon-guide catheter, 3) an ACE 64 distal aspiration catheter, and 4) an AXS Catalyst 6 Distal Access Catheter. We used a water/glycerol solution, which was kept at a constant temperature of 20°C (viscosity, 3.7 mPa · s).

RESULTS: Aspiration with the syringe and the Dominant Flex suction pump achieved the highest flows, whereas aspiration with the Pump MAX was significantly lower ( P &lt; .001). Resistors in the aspiration system (tubing, connectors, and so forth) restricted flows, especially when the resistance of the catheter was small (due to its large diameter) and the connected resistors became the predominant resistance ( P &lt; .001). The syringe achieved an average vacuum pressure of −90 kPa, and the resulting flow was constant during almost the entire procedure of filling the syringe.

CONCLUSIONS: Sixty-milliliter VacLok vacuum pressure syringes and the Dominant Flex suction pump achieved high and constant flows likely sufficient to reverse blood flow during thrombectomy with an 8F sheath or balloon-guide catheter in the ICA and modern distal aspiration catheters in the MCA. The Pump MAX aspiration pump is dedicated for use with distal aspiration catheters and is unlikely to reverse blood flow in the ICA and MCA without balloon protection." />
<meta name="og-title" property="og:title" content="Under Pressure: Comparison of Aspiration Techniques for Endovascular Mechanical Thrombectomy" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/39/5/905" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Blood flow should be interrupted during mechanical thrombectomy to prevent embolization of clot fragments. The purpose of our study was to provide a handy overview of the most common aspiration devices and to quantify their flow characteristics.

MATERIALS AND METHODS: We assessed volumetric flow rates generated by a 60-mL VacLok vacuum pressure syringe, a Pump MAX aspiration pump, and a Dominant Flex suction pump connected to the following: 1) an 8F long sheath, 2) an 8F balloon-guide catheter, 3) an ACE 64 distal aspiration catheter, and 4) an AXS Catalyst 6 Distal Access Catheter. We used a water/glycerol solution, which was kept at a constant temperature of 20°C (viscosity, 3.7 mPa · s).

RESULTS: Aspiration with the syringe and the Dominant Flex suction pump achieved the highest flows, whereas aspiration with the Pump MAX was significantly lower ( P &lt; .001). Resistors in the aspiration system (tubing, connectors, and so forth) restricted flows, especially when the resistance of the catheter was small (due to its large diameter) and the connected resistors became the predominant resistance ( P &lt; .001). The syringe achieved an average vacuum pressure of −90 kPa, and the resulting flow was constant during almost the entire procedure of filling the syringe.

CONCLUSIONS: Sixty-milliliter VacLok vacuum pressure syringes and the Dominant Flex suction pump achieved high and constant flows likely sufficient to reverse blood flow during thrombectomy with an 8F sheath or balloon-guide catheter in the ICA and modern distal aspiration catheters in the MCA. The Pump MAX aspiration pump is dedicated for use with distal aspiration catheters and is unlikely to reverse blood flow in the ICA and MCA without balloon protection." />
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      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">Interventional</span></span></div>
  
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      <h1 class="highwire-cite-title" id="page-title">Under Pressure: Comparison of Aspiration Techniques for Endovascular Mechanical Thrombectomy</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">O. Nikoubashman</span>, <span class="highwire-citation-author" data-delta="1">D. Wischer</span>, <span class="highwire-citation-author" data-delta="2">H.M. Hennemann</span>, <span class="highwire-citation-author" data-delta="3">M. Büsen</span>, <span class="highwire-citation-author" data-delta="4">C. Brockmann</span> and <span class="highwire-citation-author" data-delta="5">M. Wiesmann</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">May 2018,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">39 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(5) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">905-909; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A5605 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-60870--6265479980" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">O. Nikoubashman </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Diagnostic and Interventional Neuroradiology (O.N., D.W., H.M.H., M.W.), RWTH Aachen University Hospital, Aachen, Germany</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=O.%2BNikoubashman%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Nikoubashman%20O&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AO.%2BNikoubashman%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-2055-4217" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for O. Nikoubashman</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">D. Wischer </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Diagnostic and Interventional Neuroradiology (O.N., D.W., H.M.H., M.W.), RWTH Aachen University Hospital, Aachen, Germany</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=D.%2BWischer%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Wischer%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AD.%2BWischer%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-7787-2101" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for D. Wischer</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">H.M. Hennemann </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Diagnostic and Interventional Neuroradiology (O.N., D.W., H.M.H., M.W.), RWTH Aachen University Hospital, Aachen, Germany</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=H.M.%2BHennemann%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Hennemann%20H&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AH.M.%2BHennemann%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-9175-972X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for H.M. Hennemann</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">M. Büsen </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Institute of Applied Medical Engineering (M.B.), RWTH Aachen University, Aachen, Germany</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.%2BB%C3%BCsen%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=B%C3%BCsen%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.%2BB%25C3%25BCsen%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-9758-2892" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M. Büsen</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">C. Brockmann </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Neuroradiology (C.B.), University Medical Centre, Johannes Gutenberg University, Mainz, Germany.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=C.%2BBrockmann%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Brockmann%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AC.%2BBrockmann%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-8405-1889" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for C. 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Wiesmann </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Diagnostic and Interventional Neuroradiology (O.N., D.W., H.M.H., M.W.), RWTH Aachen University Hospital, Aachen, Germany</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.%2BWiesmann%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Wiesmann%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.%2BWiesmann%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-8261-5513" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M. 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