P021 Super large bore 0.088 inch HiPoint catheter extender and Tenzing 8 delivery catheter for the treatment of ICA terminus and M1 occlusions

<h3>Introduction</h3> Super large-bore catheters (SLBC) with a 0.088’ distal ID may generate greater aspiration force but deliverability is more challenging. The Tenzing 8 (Route 92 Medical, San Mateo, CA) shelf-reducing delivery catheter is designed to permit tracking of HiPoint 088 (Route 92 Medical, San Mateo, CA), a SLBC-extender. <h3>Aim of Study</h3> We report our initial experience with this system in the treatment of ICA terminus and M1 occlusions. <h3>Methods</h3> Using prospectively maintained institutional databases, we retrospectively reviewed clinical and angiographic data of consecutive patients who underwent off-label aspiration thrombectomy (AT) with Tenzing 8 and HiPoint 088 between 2021-2024. <h3>Results</h3> Seventy patients underwent AT with Tenzing 8/HiPoint 088 catheters: 51% female; median age 72(IQR 62-80) years; median baseline NIHSS 19(IQR 14-24); 22 ICA terminus and 48 M1 MCA occlusions. HiPoint 088 was successfully delivered to the target occlusion in 66/70(94%). A leading microwire was not needed to advance the system to the occlusion in 71%. Adjunctive thrombectomy devices were used for secondary/distal occlusions in 21%. The rate of successful revascularization (mTICI ≥ 2b) was 99%. First pass effect mTICI ≥ 2C for M1 occlusions was 65%. Median number of passes was 1 (IQR 1-2); median groin puncture to first pass time was 13(IQR 8-19) minutes with median revascularization time of 21(IQR 16-34) minutes. There were 6 procedural complications (1 cervical ICA dissection, 4 femoral artery occlusions, 1 SAH related to adjunctive device use) and 2 sICH. <h3>Conclusion</h3> High catheter delivery and reperfusion rates were achieved using Tenzing 8 and HiPoint 088, with a low complication rate. <h3>Disclosure of Interest</h3> yes Fabio Settecase, Warren Kim, Joey English: Consultant and Equity interest in Route 92 Medical. Blaise Baxter: Consultant for Stryker, Medical Device Business Services, Inc.; Honoraria: Penumbra.