P122 Soft partial release of non-aggressive stent retriever (SPORNS) – Technique for very distal arterial occlusion stroke

<h3>Introduction</h3> Endovascular thrombectomy (EVT) for very distal vessel occlusion (DVO) stroke is increasingly performed but there is insufficient evidence on efficacy and safety of distal EVT techniques. <h3>Aim of Study</h3> We evaluated a technique of soft partial release for non-aggressive stent retriever to reduce friction on perforating vessels to minimize bleeding complications. <h3>Methods</h3> Retrospective study including consecutive DVO patients who were treated with the SPORNS-technique between January 1^st2022 and December 31^st2022 at two tertiary stroke centers. DVOs were defined as isolated occlusions of the M3 and M4-segment of the middle cerebral artery, occlusions of the A2 and A3-segment of the anterior cerebral artery, and occlusions of the P1, P2-and P3-segment of the posterior cerebral artery or of the superior cerebellar artery (SCA). The SPORNS-technique is described in detail and procedural and clinical outcomes are given. <h3>Results</h3> 54 Patients were treated using SPORNS-technique of whom 50 (92%) had complete or near complete recanalization (eTICI 2c/3). NIHSS decreased from median 9 (IQR 7-13) to 3 (1-5) at admission and 41 patients (75%) achieved a good outcome (modified Rankin Scale 0-2) at day 90 post stroke. 4 patients (8%) had a small subarachnoid hemorrhage and 1 patients (4%) a symptomatic intracerebral hemorrhage on follow-up imaging. <h3>Conclusion</h3> For treatment of very distal arterial occlusions, the SPORNS- technique (soft partial release for non-aggressive stent retriever) is a safe and effective technique for thrombectomy of small clots. This technique potentially yields a lower rate of subarachnoid hemorrhages while achieving an excellent rate of complete and first pass recanalization. <h3>Disclosure of Interest</h3> no.