Abstract 198: Empty‐Lumen Aspiration Technique for Distal MCA Thrombectomy: Dry Scoop Approach Case Series

Introduction Middle cerebral artery (MCA) aspiration thrombectomy complicated by vessel lumen collapse during clot retrieval can lead to lack of incomplete clot ingestion and residual thrombus. We present a novel approach for aspiration thrombectomy to theoretically engage a larger component of the thrombus into the aspiration catheter lumen. Here, a beveled/angled tip aspiration catheter (051” OD, 035” ID) under continuous suction aspiration is navigated beyond the thrombus without the utilization of a microcatheter or microwire. We believe this method termed “Dry Scoop” technique enhances the efficiency of current aspiration techniques. Methods A prospectively maintained database of the senior author's cases was retrospectively reviewed for all mechanical thrombectomy cases from December 2024 to June 2025. Case characteristics, procedural details, and angiographic results were reviewed. Procedure success was defined as angiography after the Dry Scoop technique showing a patent vessel without contrast extravasation. Results A total of 14 cases were identified utilizing the “dry scoop” technique. Average age among the cohort was 74.5±2.2 years, with 3 females (21%). Patients presented with an NIHSS score of 11.8±2.3. Thrombus were located along the distal M1 (3 cases, 21%) and M2 (11 cases, 79%). TICI scores following interventions were TICI 3 (8 cases, 57%), TICI 2C (5 cases, 36%), TICI 2B (1 case, 7%) with an average of 2.1±0.3 passes. The procedure was successful in 12 cases (86%). First pass success with this technique was obtained in 7 cases (50%), while the remainder required additional passes (2 cases utilizing a stent retriever). There were no cases of vessel injury, dissection, nor procedure related mortality in this cohort. Conclusion The “Dry Scoop” technique for thrombectomy can be safely performed with a beveled aspiration catheter. Larger comparative reviews are needed to determine the true efficacy and safety of this procedure against conventional aspiration and stent retriever techniques, however this study demonstrates the technique was successful without added risk of vessel injury. image