P144 First-line aspiration thrombectomy of M2 occlusions with the novel RED 62 reperfusion catheter: real-world experience from two tertiary comprehensive stroke centers

<h3>Introduction</h3> The direct aspiration first pass technique (ADAPT) is an effective and safe endovascular treatment for M2 occlusions in acute ischemic stroke patients. Appropriate aspiration catheters are crucial for a successful ADAPT maneuver. <h3>Aim of Study</h3> To report technical features and initial results of a novel reperfusion catheter (RED 62) used for frontline ADAPT of acute M2 occlusions. <h3>Methods</h3> All patients treated with ADAPT using RED 62 as frontline treatment approach for acute M2 occlusions in two tertiary stroke centers (12/2022 - 02/2024) were retrospectively enrolled. Demographic data, procedural timings and safety, recanalization rates and outcome data were recorded. <h3>Results</h3> 20 patients with a median admission NIHSS score of 8 (IQR 9) were identified. Successful revascularization (DMVO-TICI ≥2b) with ADAPT was obtained in 65% (13/20). The first pass effect was 45% (9/20). In two cases, the RED 62 did not reach the clot due to marked distal vessel tortuosity. Stent retrievers were additionally used in 9 cases and led to an overall DMVO-TICI 2c/3 of 90% (18/20). Mean procedural time was 48 minutes. No complications directly related to ADAPT occurred. In-hospital mortality rate was 20% (4/20). At discharge, median NIHSS score was 2.5 (IQR 6), and 55% (11/20) had a mRS 0-2. <h3>Conclusion</h3> Our initial experience with the novel RED 62 reperfusion catheter for treatment of M2 occlusions is in line with published data. ADAPT using this catheter may be considered as a safe and effective first-line treatment option. Further studies are warranted to validate the initial results. <h3>Disclosure of Interest</h3> no.