Multicenter experience of the Monopoint reperfusion system in acute large vessel occlusion stroke thrombectomy

Published 3 days ago• 3 minute read

The Monopoint reperfusion system (Monopoint; Route 92 Medical, San Mateo, California, USA) is a large bore (0.088 or 0.070 inch inner diameter) aspiration thrombectomy platform designed to minimize ledge effect and improve neurovascular navigation and embolectomy. We aimed to describe a multicenter, real world experience of the safety and performance of the Monopoint system in first line aspiration thrombectomy for large vessel occlusions (LVOs), outside of the recently completed SUMMIT MAX (A Randomized, Controlled Trial to Evaluate the Safety and Effectiveness of the Route 92 Medical Reperfusion System) clinical trial.

Adults with acute anterior circulation LVO stroke between January 2019 and December 2024 consecutively treated with first line aspiration thrombectomy using the Monopoint at 10 centers were retrospectively reviewed. The primary outcome was first pass effect (FPE, modified Thrombolysis in Cerebral Infarction (mTICI) 2C/3 on first pass) and modified FPE (mFPE, mTICI 2B/2C/3 on first pass). The primary safety outcome was the rate of intraprocedural complications attributed to the Monopoint system.

In 193 included patients, median age was 67 years (IQR 67-78), and 46.6% (90/193) were women. Successful delivery of the aspiration catheter to the clot site occurred in 96.2% (185/193) of patients. FPE was achieved in 57.5% (111/193) and mFPE was achieved in 68.4% (132/193) of patients. Of 10 (5.2%) total complications, most were vasospasm treated with intra-arterial verapamil (8/193, 4.1%); major complications included one dissection (1/193, 0.5%) and one perforation (1/193, 0.5%).

This multicenter study of the Monopoint reperfusion system for LVO thrombectomy outside of the SUMMIT MAX trial demonstrated a high FPE rate and a low rate of major complications.

Device; Intervention; Reperfusion; Stroke; Thrombectomy.

PubMed Disclaimer

Competing interests: DT: advisory board for Route 92 and consultant for Scientia and IRRAS. FS: research funding from Medtronic, Microvention, and Stryker; consultant for Route 92 and Stryker; honorarium from Stryker; and equity in Route 92. JE: consultant for Route 92 and Stryker; and equity in Route 92. MDA: consulting and equity for Route 92 and Certus Critical Care; consulting for Medtronic and Cerenovus; and equity in Piraeus Medical. OG: consultant for Microvention, Stryker, Rapid Medical, and Route92. PJP: consultant for Route 92 and Microvention; and proctor for Microvention. TNN: associate editor of Stroke; advisory board of Brainomix and Aruna Bio; speaker for Genentech and Kaneka; and consulting for Medtronic. WK: consultant for Route 92 and Stryker; and equity in Route 92. BWB: consulting for Cerenovus, Penumbra, Stryker, and Route 92 (consulting contract ended October 2021), OcuDyne, Artio (now Amplifi Vascular), Acotec Technologies, Hyperfine Operations, NeuroVasc Technologies, DeepIn Technologies, Euphrates Vascular, and iSchemaView; honoraria/speaker fees from Cerenovus, Penumbra, Stryker, Zylox-Tonbridge Medical Company, and OcuDyne iSchemaView–RapidAI; travel support from Cerenovus, Penumbra, Route 92 Medical, Artio (now Amplifi Vascular), and Acotec Technologies; data safety monitoring board or advisory board for Stryker and Cerenovus; past president of Society of Neurointerventional Surgery; stock or stock options in Route 92 Medical, Artio (now Amplifi Vascular), Ceroflo, DeVoro Medical, Marblehead Medical, Sublime Laser, Viz.ai, and Rapid Medical; other financial or non-financial interests in Route 92 (employee, chief clinical officer, October 2021 to February 2022), Artio (now Amplifi Vascular; employee, vice president of neurointerventional and peripheral vascular interventions, then chief medical officer, October 31, 2021 to November 30, 2022). AJT: equity in Qure.ai. TK-H: consultant for Route 92. TGJ: consultant for Contego Medical; grants from Medtronic and Stryker; data safety monitoring for Cerenovus; ownership/investment interest in Anaconda, StataDx, Galaxy, Basking, Freeox Biotech, Kandu, Viz-AI, Route92, and Gravity.

Origin: