Mechanical Thrombectomy with the Vecta 46 Catheter: A Safety and Outcome Analysis
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design and Population
2.2. Data Collection
2.3. Outcomes
2.4. Statistical Analysis
3. Results
3.1. Baseline Characteristics of Patients
3.2. Procedure Details
3.3. Outcomes
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
| LVO | Large vessel occlusion |
| MT | Mechanical thrombectomy |
| SR | Stent retriever |
| MeVO | Medium vessel occlusion |
References
- Sarraj, A.; Hassan, A.E.; Abraham, M.G.; Ortega-Gutierrez, S.; Kasner, S.E.; Hussain, M.S.; Chen, M.; Blackburn, S.; Sitton, C.W.; Churilov, L.; et al. Trial of Endovascular Thrombectomy for Large Ischemic Strokes. N. Engl. J. Med. 2023, 388, 1259–1271. [Google Scholar] [CrossRef]
- Elgendy, I.Y.; Kumbhani, D.J.; Mahmoud, A.; Bhatt, D.L.; Bavry, A.A. Mechanical Thrombectomy for Acute Ischemic Stroke: A Meta-Analysis of Randomized Trials. J. Am. Coll. Cardiol. 2015, 66, 2498–2505. [Google Scholar] [CrossRef]
- Costalat, V.; Jovin, T.G.; Albucher, J.F.; Cognard, C.; Henon, H.; Nouri, N.; Gory, B.; Richard, S.; Marnat, G.; Sibon, I.; et al. Trial of Thrombectomy for Stroke with a Large Infarct of Unrestricted Size. N. Engl. J. Med. 2024, 390, 1677–1689. [Google Scholar] [CrossRef]
- Albers, G.W.; Marks, M.P.; Kemp, S.; Christensen, S.; Tsai, J.P.; Ortega-Gutierrez, S.; McTaggart, R.A.; Torbey, M.T.; Kim-Tenser, M.; Leslie-Mazwi, T.; et al. Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging. N. Engl. J. Med. 2018, 378, 708–718. [Google Scholar] [CrossRef]
- Berkhemer, O.A.; Fransen, P.S.S.; Beumer, D.; van den Berg, L.A.; Lingsma, H.F.; Yoo, A.J.; Schonewille, W.J.; Vos, J.A.; Nederkoorn, P.J.; Wermer, M.J.H.; et al. A Randomized Trial of Intraarterial Treatment for Acute Ischemic Stroke. N. Engl. J. Med. 2015, 372, 11–20. [Google Scholar] [CrossRef]
- Campbell, B.C.V.; Mitchell, P.J.; Kleinig, T.J.; Dewey, H.M.; Churilov, L.; Yassi, N.; Yan, B.; Dowling, R.J.; Parsons, M.W.; Oxley, T.J.; et al. Endovascular Therapy for Ischemic Stroke with Perfusion-Imaging Selection. N. Engl. J. Med. 2015, 372, 1009–1018. [Google Scholar] [CrossRef] [PubMed]
- Goyal, M.; Demchuk, A.M.; Menon, B.K.; Eesa, M.; Rempel, J.L.; Thornton, J.; Roy, D.; Jovin, T.G.; Willinsky, R.A.; Sapkota, B.L.; et al. Randomized Assessment of Rapid Endovascular Treatment of Ischemic Stroke. N. Engl. J. Med. 2015, 372, 1019–1030. [Google Scholar] [CrossRef] [PubMed]
- Jovin, T.G.; Chamorro, A.; Cobo, E.; de Miquel, M.A.; Molina, C.A.; Rovira, A.; San Román, L.; Serena, J.; Abilleira, S.; Ribó, M.; et al. Thrombectomy within 8 Hours after Symptom Onset in Ischemic Stroke. N. Engl. J. Med. 2015, 372, 2296–2306. [Google Scholar] [CrossRef] [PubMed]
- Nogueira, R.G.; Jadhav, A.P.; Haussen, D.C.; Bonafe, A.; Budzik, R.F.; Bhuva, P.; Yavagal, D.R.; Ribo, M.; Cognard, C.; Hanel, R.A.; et al. Thrombectomy 6 to 24 Hours after Stroke with a Mismatch between Deficit and Infarct. N. Engl. J. Med. 2018, 378, 11–21. [Google Scholar] [CrossRef]
- Turc, G.; Bhogal, P.; Fischer, U.; Khatri, P.; Lobotesis, K.; Mazighi, M.; Schellinger, P.D.; Toni, D.; De Vries, J.; White, P.; et al. European Stroke Organisation (ESO)—European Society for Minimally Invasive Neurological Therapy (ESMINT) Guidelines on Mechanical Thrombectomy in Acute Ischaemic StrokeEndorsed by Stroke Alliance for Europe (SAFE). Eur. Stroke J. 2019, 4, 6–12. [Google Scholar] [CrossRef]
- Powers, W.J.; Rabinstein, A.A.; Ackerson, T.; Adeoye, O.M.; Bambakidis, N.C.; Becker, K.; Biller, J.; Brown, M.; Demaerschalk, B.M.; Hoh, B.; et al. Guidelines for the Early Management of Patients with Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke 2019, 50, e344–e418. [Google Scholar] [CrossRef]
- Saber, H.; Narayanan, S.; Palla, M.; Saver, J.L.; Nogueira, R.G.; Yoo, A.J.; Sheth, S.A. Mechanical Thrombectomy for Acute Ischemic Stroke with Occlusion of the M2 Segment of the Middle Cerebral Artery: A Meta-Analysis. J. Neurointerv. Surg. 2018, 10, 620–624. [Google Scholar] [CrossRef]
- Goyal, M.; Ospel, J.M.; Ganesh, A.; Dowlatshahi, D.; Volders, D.; Möhlenbruch, M.A.; Jumaa, M.A.; Nimjee, S.M.; Booth, T.C.; Buck, B.H.; et al. Endovascular Treatment of Stroke Due to Medium-Vessel Occlusion. N. Engl. J. Med. 2025, 392, 1385–1395. [Google Scholar] [CrossRef]
- Psychogios, M.; Brehm, A.; Ribo, M.; Rizzo, F.; Strbian, D.; Räty, S.; Arenillas, J.F.; Martínez-Galdámez, M.; Hajdu, S.D.; Michel, P.; et al. Endovascular Treatment for Stroke Due to Occlusion of Medium or Distal Vessels. N. Engl. J. Med. 2025, 392, 1374–1384. [Google Scholar] [CrossRef]
- Goyal, N.; Khattar, N.K.; Peterson, J.; Dashti, R.; Sims, J.J.; Baumeister, M.; Williams, A.; Amadi, I.; Ebersole, K.; Madigan, D.; et al. The RED 43 Catheter for Aspiration Thrombectomy of Distal Medium Vessel Occlusions (DMVOs): A Multicenter Experience. J. Neurointerv. Surg. 2025, 18, 684–689. [Google Scholar] [CrossRef] [PubMed]
- Russo, R.; Mistretta, F.; Molinaro, S.; Bergui, M. 5F SOFIA Intermediate Catheter in the Treatment of Acute Ischemic Stroke: A Retrospective Observational Study. Interv. Neuroradiol. 2023, 29, 583–588. [Google Scholar] [CrossRef]
- Choi, J.W.; Qiao, Y.; Mehta, T.I.; Clausen, T.M.; Zhang, Y.J.; Tsappidi, S.; Hui, F.K. The Vecta 46 Intermediate Catheter for Mechanical Thrombectomy of Distal Medium Vessel Occlusions: A Single-Center Experience. Interv. Neuroradiol. 2024, 15910199241283513. [Google Scholar] [CrossRef]
- Dornbos, D.; Arthur, A.S. Current State of the Art in Endovascular Stroke Treatment. Neurol. Clin. 2022, 40, 309–319. [Google Scholar] [CrossRef]
- Bai, X.; Zhang, X.; Gong, H.; Wang, T.; Wang, X.; Wang, W.; Yang, K.; Yang, W.; Feng, Y.; Ma, Y.; et al. Different Types of Percutaneous Endovascular Interventions for Acute Ischemic Stroke. Cochrane Database Syst. Rev. 2023, 5, CD014676. [Google Scholar] [CrossRef] [PubMed]
- Nguyen, T.N.; Dabus, G.; McGuinness, B.; Caldwell, J.; Priest, R.; Rai, A.T.; Zaidat, O.O.; Gross, B.A.; Hanel, R.; Lee, S.; et al. SUMMIT MAX: A Randomized Trial of the Super Large Bore HiPoint Reperfusion System Versus Vecta System for Aspiration Thrombectomy. Stroke 2025, 56, 1980–1990. [Google Scholar] [CrossRef] [PubMed]
- Eskey, C.J.; Meyers, P.M.; Nguyen, T.N.; Ansari, S.A.; Jayaraman, M.; McDougall, C.G.; DeMarco, J.K.; Gray, W.A.; Hess, D.C.; Higashida, R.T.; et al. Indications for the Performance of Intracranial Endovascular Neurointerventional Procedures: A Scientific Statement From the American Heart Association. Circulation 2018, 137, e661–e689. [Google Scholar] [CrossRef]
- Bourcier, R.; Goyal, M.; Liebeskind, D.S.; Muir, K.W.; Desal, H.; Siddiqui, A.H.; Dippel, D.W.J.; Majoie, C.B.; van Zwam, W.H.; Jovin, T.G.; et al. Association of Time From Stroke Onset to Groin Puncture with Quality of Reperfusion After Mechanical Thrombectomy: A Meta-Analysis of Individual Patient Data from 7 Randomized Clinical Trials. JAMA Neurol. 2019, 76, 405–411. [Google Scholar] [CrossRef]
- Jahan, R.; Saver, J.L.; Schwamm, L.H.; Fonarow, G.C.; Liang, L.; Matsouaka, R.A.; Xian, Y.; Holmes, D.N.; Peterson, E.D.; Yavagal, D.; et al. Association Between Time to Treatment with Endovascular Reperfusion Therapy and Outcomes in Patients with Acute Ischemic Stroke Treated in Clinical Practice. JAMA 2019, 322, 252–263. [Google Scholar] [CrossRef] [PubMed]
- Mulder, M.J.H.L.; Jansen, I.G.H.; Goldhoorn, R.-J.B.; Venema, E.; Chalos, V.; Compagne, K.C.J.; Roozenbeek, B.; Lingsma, H.F.; Schonewille, W.J.; van den Wijngaard, I.R.; et al. Time to Endovascular Treatment and Outcome in Acute Ischemic Stroke: MR CLEAN Registry Results. Circulation 2018, 138, 232–240. [Google Scholar] [CrossRef] [PubMed]
- Primiani, C.T.; Vicente, A.C.; Brannick, M.T.; Turk, A.S.; Mocco, J.; Levy, E.I.; Siddiqui, A.H.; Mokin, M. Direct Aspiration versus Stent Retriever Thrombectomy for Acute Stroke: A Systematic Review and Meta-Analysis in 9127 Patients. J. Stroke Cerebrovasc. Dis. 2019, 28, 1329–1337. [Google Scholar] [CrossRef]
- Alawieh, A.; Chatterjee, A.R.; Vargas, J.; Chaudry, M.I.; Lena, J.; Turner, R.; Turk, A.; Spiotta, A. Lessons Learned Over More than 500 Stroke Thrombectomies Using ADAPT with Increasing Aspiration Catheter Size. Neurosurgery 2020, 86, 61–70. [Google Scholar] [CrossRef] [PubMed]
- Le Blanc, M.; Maus, V.; Kabbasch, C.; Dorn, F.; Chang, D.-H.; Liebig, T.; Mpotsaris, A.; Borggrefe, J. Effects of Intermediate Catheter Evolution on Technical Outcome of Mechanical Thrombectomy-A Comparison of the Performance of Two Distal Access Catheters in Mechanical Thrombectomy of Acute Ischemic Stroke. World Neurosurg. 2019, 123, e433–e439. [Google Scholar] [CrossRef]
- Texakalidis, P.; Giannopoulos, S.; Karasavvidis, T.; Rangel-Castilla, L.; Rivet, D.J.; Reavey-Cantwell, J. Mechanical Thrombectomy in Acute Ischemic Stroke: A Meta-Analysis of Stent Retrievers vs Direct Aspiration vs a Combined Approach. Neurosurgery 2020, 86, 464–477. [Google Scholar] [CrossRef]

| Total n = 172 | Vecta 46 n = 32 | Non-Vecta 46 n = 140 | p-Value | |
|---|---|---|---|---|
| Age (years) | 69.47 ± 16.0 | 68.7 ± 17.8 | 69.4 ± 14.9 | 0.537 |
| Patient Sex | 0.715 | |||
| Male | 91 (53%) | 16 (50%) | 75 (54%) | |
| Female | 81 (47%) | 16 (50%) | 65 (46%) | |
| Risk Factors | ||||
| Atrial Fibrillation | 41 (24%) | 4 (13%) | 37 (26%) | 0.095 |
| Diabetes Mellitus | 28 (16%) | 7 (22%) | 21 (15%) | 0.342 |
| Hypertension | 114 (66%) | 22 (69%) | 92 (66%) | 0.743 |
| CAD | 45 (26%) | 6 (19%) | 39 (28%) | 0.290 |
| CVA/TIA | 30 (17%) | 5 (16%) | 25 (18%) | 0.764 |
| Smoking | 51 (30%) | 7 (22%) | 44 (31%) | 0.286 |
| Baseline mRS | 0.615 ± 1.14 | 0.813 ± 1.62 | 0.570 ± 1.01 | 0.804 |
| NIHSS on Admission | 17.2 ± 8.15 | 17.2 ± 10.1 | 17.2 ± 7.66 | 0.758 |
| Total n = 172 | Vecta 46 n = 32 | Non-Vecta 46 n = 140 | p-Value | |
|---|---|---|---|---|
| Treatment Strategy | 0.010 | |||
| ADAPT | 88 (51%) | 70 (50%) | 18 (56%) | |
| ADAPT Fail, Stentriever Rescue | 31 (18%) | 25 (18%) | 6 (19%) | |
| Stentriever | 41 (24%) | 37 (26%) | 4 (13%) | |
| Stentriever Fail, ADAPT Rescue | 5 (2.9%) | 1 (0.7%) | 4 (13%) | |
| Other Techniques | 7 (4.1%) | 7 (5.0%) | 0 | |
| Number of Attempts of Aspiration | 1.23 ± 0.748 | 1.66 ± 0.936 | 1.12 ± 0.650 | 0.001 |
| Number of Attempts of SR | 1.46 ± 1.44 | 1.79 ± 2.15 | 1.38 ± 1.23 | 0.866 |
| Primary Vessel Occlusion Site | 0.027 | |||
| Basilar | 9 (5.2%) | 1 (3.1%) | 8 (5.7%) | |
| CCA | 3 (1.7%) | 0 (0%) | 3 (2.1%) | |
| ICA | 8 (4.6%) | 0 (0%) | 8 (5.7%) | |
| M1 | 100 (58%) | 14 (44%) | 86 (61%) | |
| M2 | 44 (25%) | 13 (41%) | 31 (22%) | |
| M3 | 4 (2.3%) | 3 (9.4%) | 1 (0.7%) | |
| P1 | 2 (1.2%) | 0 (0%) | 2 (1.4%) | |
| P2 | 1 (0.6%) | 0 (0%) | 1 (0.7%) | |
| Vertebral | 2 (1.2%) | 1 (3.1%) | 1 (0.7%) | |
| Secondary Thrombus Aspirated | 20 (14.1%) | 12 (37.5%) | 29 | 0.0314 |
| Secondary Occlusion Location | 0.843 | |||
| A1 | 2 (1.2%) | 0 (0%) | 2 (1.4%) | |
| A2 | 3 (1.7%) | 1 (3.1%) | 2 (1.4%) | |
| Basilar | 9 (5.2%) | 1 (3.1%) | 8 (5.7%) | |
| CCA | 3 (1.7%) | 0 (0%) | 3 (2.1%) | |
| ICA | 8 (4.6%) | 0 (0%) | 8 (5.7%) | |
| M1 | 98 (57%) | 14 (44%) | 84 (60%) | |
| M2 | 41 (24%) | 12 (38%) | 29 (21%) | |
| M3 | 4 (2.3%) | 3 (9.4%) | 1 (0.7%) |
| Total n = 172 | Non-Vecta 46 n = 140 | Vecta 46 n = 32 | p-Value | |
|---|---|---|---|---|
| Successful Recanalization | 172 (98.9%) | 141 (99.3%) | 31 (96.9%) | 0.800 |
| Time to Recanalization (Minutes) | 23.0 ± 19.3 | 23.1 ± 20.8 | 22.6 ± 11.1 | 0.245 |
| Procedure Duration (Minutes) | 56.0 ± 41.42 | 57.8 ± 43.92 | 47.6 ± 26.4 | 0.580 |
| Discharge mRS Score | 2.82 ± 2.07 | 2.82 ± 2.06 | 2.81 ± 2.16 | 0.875 |
| ICH | 12 (6.90%) | 8 (5.63%) | 4 (12.5%) | 0.720 |
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Hutchinson, H.; DeYoung, C.; Sarathy, D.; Hey, G.; Gillam, W.; Amini, S.; Chowdhury, M.A.B.; Lucke-Wold, B.; Sorrentino, Z.; Koch, M. Mechanical Thrombectomy with the Vecta 46 Catheter: A Safety and Outcome Analysis. J. Vasc. Dis. 2026, 5, 20. https://doi.org/10.3390/jvd5030020
Hutchinson H, DeYoung C, Sarathy D, Hey G, Gillam W, Amini S, Chowdhury MAB, Lucke-Wold B, Sorrentino Z, Koch M. Mechanical Thrombectomy with the Vecta 46 Catheter: A Safety and Outcome Analysis. Journal of Vascular Diseases. 2026; 5(3):20. https://doi.org/10.3390/jvd5030020
Chicago/Turabian StyleHutchinson, Hunter, Chloe DeYoung, Danyas Sarathy, Grace Hey, Wiley Gillam, Shawna Amini, Muhammad Abdul Baker Chowdhury, Brandon Lucke-Wold, Zachary Sorrentino, and Matthew Koch. 2026. "Mechanical Thrombectomy with the Vecta 46 Catheter: A Safety and Outcome Analysis" Journal of Vascular Diseases 5, no. 3: 20. https://doi.org/10.3390/jvd5030020
APA StyleHutchinson, H., DeYoung, C., Sarathy, D., Hey, G., Gillam, W., Amini, S., Chowdhury, M. A. B., Lucke-Wold, B., Sorrentino, Z., & Koch, M. (2026). Mechanical Thrombectomy with the Vecta 46 Catheter: A Safety and Outcome Analysis. Journal of Vascular Diseases, 5(3), 20. https://doi.org/10.3390/jvd5030020

