Original Research Article

The impact of microcatheter-to-vessel size ratio on distal embolization during mechanical thrombectomy—an in vitro quantitative study: Comparative study of different microcatheter sizes in different neurovascular models

This study investigated the impact of microcatheter-to-vessel size ratio on distal embolization during mechanical thrombectomy (MT). Using clot analogs in a 3D-printed neurovascular model, three microcatheter sizes (0.017″, 0.021″, 0.027″) were tested across vessels of 2.0, 2.5, and 3.5 mm diameters. A total of 180 experiments were performed, with and without microguidewire assistance. Results showed that larger microcatheters, especially 0.027″, caused more distal emboli, particularly in smaller (2 mm) vessels. A microcatheter-to-vessel ratio ≥0.38 significantly increased the embolic risk. The use of a microguidewire did not affect embolization outcomes. The findings suggest that careful selection of microcatheter size based on vessel diameter is crucial to reducing periprocedural distal embolization in MT.

Impression: This study highlights that microcatheter size relative to vessel diameter significantly impacts distal embolization risk. While wire use alone did not affect outcomes, these findings provide practical guidance for microcatheter and wire selection, especially in smaller vessels. Understanding device-to-vessel ratio can aid clinicians in minimizing complications during mechanical thrombectomy.

From Stroke Research, Vall d'Hebron Research Institute, Passeig Vall d’Hebron 119-129, 08035 Barcelona. Spain.

View at: https://doi.org/10.1177/15910199251359359

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