Journal of Cerebrovascular and Endovascular Neurosurgery

Korean Society of Cerebravascular Surgeons (대한뇌혈관외과학회)
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Optimizing suction force in mechanical thrombectomy: Priming the aspiration tubing with air versus saline

  • Arvin R. Wali (Department of Neurological Surgery, University of California) ;
  • Ryan W. Sindewald (Department of Neurological Surgery, University of California) ;
  • Michael G. Brandel (Department of Neurological Surgery, University of California) ;
  • Javier Bravo (Department of General Surgery, University of California) ;
  • Jeffrey A. Steinberg (Department of Neurological Surgery, University of California) ;
  • J. Scott Pannell (Department of Neurological Surgery, University of California) ;
  • Alexander A. Khalessi (Department of Neurological Surgery, University of California) ;
  • David R. Santiago-Dieppa (Department of Neurological Surgery, University of California)
  • Received : 2023.08.23
  • Accepted : 2024.01.29
  • Published : 2024.09.30
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Abstract

Objective: We sought to investigate how priming the tube between air versus air mixed with saline ex vivo influenced suction force. We examined how priming the tube influenced peak suction force and time to achieve peak suction force between both modalities. Methods: Using a Dwyer Instruments (Dwyer Instruments Inc., Michigan City, IN, USA), INC Digitial Pressure Gauge, we were able to connect a .072 inch aspiration catheter to a rotating hemostatic valve and to aspiration tubing. We recorded suction force measured in negative inches of Mercury (inHg) over 10 iterations between having the aspiration tube primed with air alone versus air mixed with saline. A test was used to compare results between both modalities. Results: Priming the tube with air alone compared to air mixed with saline was found to have an increased average max suction force (-28.60 versus -28.20 in HG, p<0.01). We also identified a logarithmic curve of suction force across time in which time to maximal suction force was more prompt with air compared with air mixed with saline (13.8 seconds versus 21.60 seconds, p<0.01). Conclusions: Priming the tube with air compared to air mixed with saline suggests that not only is increased maximal suction force achieved, but also the time required to achieve maximal suction force is less. This data suggests against priming the aspiration tubing with saline and suggests that the first pass aspiration primed with air may have the greatest suction force.

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Acknowledgement

This work was previously presented at CNS 2023.

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