{
  "abstract": "Introduction The non-continuous aspiration technique (NCAT) and continuous dual-aspiration technique (CDAT) results were quantified in an in-vitro setting. NCAT is aspiration via pump vacuum at the inner aspiration catheter and syringe vacuum at the outer support catheter. CDAT is aspiration via simultaneous pump vacuum at the inner and outer catheters. Previous in-vitro assessments showed that a second aspiration catheter increased the likelihood of fully aspirating the clot relative to a singular aspiration catheter. This study quantified the aspiration flowrates generated by NCAT and CDAT in a controlled and comprehensive flow model.Methods All tests were performed in a Simulated Surgical Suite at Northern Arizona University. The flow model consisted of a patient-specific pulsatile pump, blood-analog, radiopaque synthetic clots, and 3D-printed tissue-matched circle of Willis (CW) models. Flowrate and pressure changes were measured in real-time in each CW vessel branch. Clot aspiration and inner/outer catheter positioning were recorded via fluoroscopy and an HD webcam. The blood flow changes during aspiration in the middle cerebral artery superior (M2S) and inferior branches (M2I) were monitored in real-time with three inner/outer catheter combinations: Zoom 7X/88, Zoom 4S/7X, and Zoom 4S/88 (Imperative Care). Studies were repeated three times (n=3) for both clot and control aspirations (no thrombus). Thrombus sizes were pre-determined based on clot-to-catheter ratio for occluding the M2S (inner catheter - Zoom 4S) and M1 (inner catheter - Zoom 7X) respectively. Blood flows were recorded pre-aspiration, during dual aspiration (flow while inner catheter is retracted to the tip of the outer catheter), and when the inner catheter tip was retracted to the rotating hemostatic valve (RHV - position where outer catheter begins aspiration).Results Flow returned (50-90% restoration) to the occluded vessel branch at the start of dual aspiration with the lowest flowrate at the RHV (10-40%), indicating maximum outer aspiration. CDAT had less flowrate reduction in comparison to the NCAT setup (30-40% vs. 10-25% for RHV-drop), but with increased flowrate consistency (error bars, figure 1). However, syringes have small vacuum volumes (~60cc vs. 1000cc) resulting in shorter maximum aspiration time than the pump (10s vs. 3-5min).Conclusion The CDAT setup can maintain steady-state flow in the CW, whereas the NCAT flow effect is not steady-state, resulting in significantly less overall flow effects in the CW with NCAT. This effect is particularly evident within the RHV. Results from this study indicate more efficient aspiration for CDAT than NCAT or single aspiration.Disclosures S. Schwartz: 1; C; Imperative Care, Northern Arizona University. 5; C; Northern Arizona University. 6; C; Imperative Care. K. Lewis: 1; C; Imperative Care, Northern Arizona University. 5; C; Aneuvas Technologies, Inc.. 6; C; Imperative Care. C. Barton: 1; C; Imperative Care, Northern Arizona University. 5; C; Northern Arizona University. 6; C; Imperative Care. J. Wells: 1; C; Imperative Care, Northern Arizona University. 5; C; Aneuvas Technologies, Inc., Northern Arizona University. 6; C; Imperative Care. C. Rappoport: 1; C; Imperative Care, Northern Arizona University. 5; C; Northern Arizona University. 6; C; Imperative Care. A. Wintermantel: 1; C; Imperative Care, Northern Arizona University. 5; C; Northern Arizona University. 6; C; Imperative Care. W.E. Clark: 1; C; Imperative Care, Northern Arizona University. 5; C; Aneuvas Technologies, Inc.. 6; C; Imperative Care. S. Robertson: 1; C; Northern Arizona University, Imperative Care. 5; C; Aneuvas Technologies, Inc.. 6; C; Imperative Care. T. Becker: 1; C; Imperative Care, Northern Arizona University. 5; C; Northern Arizona University, Aneuvas Technologies Inc.. 6; C; Imperative Care.Abstract E-123 Figure 1Percentage ratio of flowrate (average flow/original, unobstructed flow) for CW M2 segments before aspiration (blue), primary and secondary catheter alignment during dual aspiration (green), and aspiration when the primary catheter reaches the RHV (pink) A) Zoom 7X-88, B) Zoom 4S-7X-88, C) Zoom 4S-88",
  "authors": [
    {
      "affiliations": [
        "Bioengineering Devices Lab, Northern Arizona University, Flagstaff, AZ"
      ],
      "name": "S Schwartz"
    },
    {
      "affiliations": [
        "Bioengineering Devices Lab, Northern Arizona University, Flagstaff, AZ"
      ],
      "name": "K Lewis"
    },
    {
      "affiliations": [
        "Bioengineering Devices Lab, Northern Arizona University, Flagstaff, AZ"
      ],
      "name": "C Barton"
    },
    {
      "affiliations": [
        "Bioengineering Devices Lab, Northern Arizona University, Flagstaff, AZ"
      ],
      "name": "J Wells"
    },
    {
      "affiliations": [
        "Bioengineering Devices Lab, Northern Arizona University, Flagstaff, AZ"
      ],
      "name": "C Rappoport"
    },
    {
      "affiliations": [
        "Bioengineering Devices Lab, Northern Arizona University, Flagstaff, AZ"
      ],
      "name": "A Wintermantel"
    },
    {
      "affiliations": [
        "Bioengineering Devices Lab, Northern Arizona University, Flagstaff, AZ"
      ],
      "name": "WE Clark"
    },
    {
      "affiliations": [
        "Bioengineering Devices Lab, Northern Arizona University, Flagstaff, AZ"
      ],
      "name": "S Robertson"
    },
    {
      "affiliations": [
        "Bioengineering Devices Lab, Northern Arizona University, Flagstaff, AZ"
      ],
      "name": "T Becker"
    }
  ],
  "title": "E-123 In-vitro mechanical evaluation of the novel continuous dual aspiration and non-continuous aspiration technique",
  "uid": "fc822cab-421a-504f-82e6-c5f2f35836ce"
}