Mechanical Thrombectomy with the Vecta 46 Catheter: A Safety and Outcome Analysis

2. Abstract Background The AXS Vecta 46 intermediate catheter (Stryker) provides a large enough inner diameter to achieve effective aspiration with a small enough outer diameter and soft distal-tip flexibility to track safely through more tortuous and smaller arterial segments to non-traumatically target medium vessel occlusions. The efficacy of the Vecta 46 in the spectrum of large and medium vessel occlusions has not been well elucidated in the literature. Methods This retrospective cohort study included patients who underwent MT for acute ischemic stroke at the University of Florida between July 2022 and June 2024. The outcomes of patients treated with the Vecta 46 was compared to that of all other catheters used at the institution. Results The distribution of aspiration and stent retriever attempts in Vecta 46 procedures versus non-Vecta 46 procedures was significantly different (p = 0.00325). Aspiration was attempted 1.66 ± 0.936 times in the Vecta 46 group and 1.12 ± 0.650 times in the non-Vecta 46 group (p = 0.00135). More mechanical thrombectomies with the Vecta 46 included aspiration of a secondary thrombus (p = 0.0314), despite no difference in distribution of primary or secondary occlusion location. There were no statistically significant differences in recanalization success (p = 0.800), recanalization time (p = 0.245), procedure duration (p = 0.580), discharge modified Rankin Score (p = 0.875), or intracranial hemorrhage rate (p = 0.720) between non-Vecta 46 and Vecta 46 procedures. Conclusions Vecta 46 has similar safety and functional outcomes compared to other endovascular treatment options despite procedural differences.