P151 Trevo 3 mm and/or AXS catalyst 5 for the treatment of medium distal vessel occlusion stroke – results from the ASSIST registry

<h3>Introduction</h3> The effect of endovascular therapy (EVT) on the outcome of medium distal vessel occlusions (MDVO) is unclear. <h3>Aim of Study</h3> To report the results of MDVOs treated with the Trevo-3mm-Stent-Retriver(SR) and/or the AXS-Catalyst5 distal access catheter(DAC). <h3>Methods</h3> Data was derived from a prospective, multicenter global registry (ASSIST registry) which enrolled patients treated with operator preferred EVT technique at 71 sites from January 2019 to January 2022. Three techniques were assessed: SR classic, direct aspiration, and a combined approach. Additional inclusion criteria were (a) EVT performed with the Trevo-3mm-SR and/or AXS Catalyst5 (DAC) on the first pass and (b) an occlusion of medium/distal vesels. The primary outcome was achieving an expanded Thrombolysis in Cerebral Infarction (eTICI) score of 2c/3 on the first pass, with the primary technique as adjudicated by core lab. The primary clinical outcome measure was a 90-day modified Rankin Scale (mRS) score of 0-2.…. <h3>Results</h3> A total of 155 patients (10.4% of the ASSIST population) were included. Most patients had an M2 occlusion (93.5%). First pass eTICI reperfusion was achieved in 43.1% of the patients. No modifying effect of the frontline technique was found. The rate of mRS 0 – 2 (overall 65.0%) did not significantly differ between groups. <h3>Conclusion</h3> The data suggests that the Trevo3mm SR and/or the AXS-Catalyst5 may be an option to treat MDVOs, but more data is needed to demonstrate safety and efficacy in this patient cohort. Further improvements are needed regarding materials and techniques to improve reperfusion results in this patient-group.