ABSTRACT NUMBER: ESOC2026A2113 EFFECTIVENESS AND SAFETY OF THE TIGERTRIEVER 17 AS FIRST-LINE DEVICE FOR MECHANICAL THROMBECTOMY IN DISTAL MEDIUM VESSEL OCCLUSIONS

Abstract Background and aims Mechanical thrombectomy (MT) for distal medium vessel occlusions (DMVO) in acute ischemic stroke (AIS) remains technically challenging, and evidence for dedicated devices is limited. The Tigertriever 17 is a manually expandable stent retriever designed for small-caliber, tortuous intracranial vessels. This study evaluated its safety and effectiveness when used as a first-line device for MT in DMVO. Methods This retrospective, multicenter observational study included patients with AIS due to DMVO treated between January 2024 and May 2025 using the Tigertriever 17 as a first-line thrombectomy device. Data were collected from three high-volume stroke centers in Germany. Inclusion required a neurological deficit and radiological evidence of DMVO. The primary endpoint was successful reperfusion (modified Thrombolysis in Cerebral Infarction score ≥2b). Secondary endpoints included symptomatic and non-symptomatic intracranial hemorrhage. Subgroup analyses were performed for co-aspiration use and M2/M3 occlusions. Results Fifty-five patients were included. Overall successful reperfusion was achieved in 46/55 patients (83.6%). In the co-aspiration subgroup (n=42), reperfusion was achieved in 37/42 patients (88.1%). Among patients with M2–M3 occlusions treated with co-aspiration (n=40), successful reperfusion occurred in 35/40 cases (87.5%). Rescue maneuvers were required in nine cases, achieving reperfusion in seven. No symptomatic intracranial hemorrhages occurred. Four non-symptomatic hemorrhages were observed, three unrelated to the device and one of unclear association. Conclusions This multicenter analysis suggests that the Tigertriever 17 is a safe and effective first-line device for MT in DMVO. Reperfusion rates, particularly with co-aspiration, exceeded historical benchmarks and support further prospective evaluation. Conflict of interest 1) P. Melessanakis: No conflicts of interest 2) L. Voss: No conflicts of interest 3) S. Fischer: SF received travel grants and speaker honoraria from Rapid Medical 4) P. Stracke: PS received travel grants and speaker honoraria from Rapid Medical 5) B. Turowski: No conflicts of interest 6) H. Nordmeyer: HN received travel grants and speaker honoraria from Rapid Medical