Abstract
INTRODUCTION: Superbore aspiration with catheters ≥0.088inlumen diameter has emerged asa promising techniquefor clot removal in stroke. The MillipedeSystem (Perfuze, Ireland)comprisesthe Millipede88and Millipede70Aspiration Catheters and Aspiration Tube Setand employs a direct aspiration first‐passtechniquefor thrombus removal in intracraniallarge‐vessel occlusive disease. AIMOF THE STUDY: The MillipedeAspiRation for Revascularization in Stroke (MARRS)pivotalstudy is a prospective, interventional, open‐label,single‐arm, multicenter clinicalinvestigation designed to assess the performance and safety characteristics of the MillipedeSystem for revascularization in patients with acute ischemic stroke due to large vesselocclusions within 8hours. METHODS: Enrolment was completed across 22sites in the United States and Europe.180subjects with occlusions of the ICA (26%),M1(62%),M2(9%),and basilar artery (3%)weretreated. The median age was 69,with a similar distribution of males (51%)and females(49%).The mean baseline NIHSS score was 17and mean baseline ASPECTS was 8.6. RESULTS: Based on preliminary analysis of the Per Protocol population, which excludedpatients with major eligibility deviations, the rate of First Pass Effect mTICI ≥2c(FPE)was57%.In those treated using direct aspiration with Millipede88on the first pass,the rate ofFPE was 77%in the MCA. The rate of final mTICI ≥ 2cacross all occlusion locations was 86%.Delivery of Millipedeto the clot was 99%.Rates of sICH and intracranial dissection were1.7%and 1.1%respectively. There were no statistically significant differences betweenhigher and lower enrolling sites (Top3vs Overall, ≥10Subjects vs < 10Subjects)in terms ofFPE or successful reperfusion,potentially indicating an intuitive design, ease of use, andconsistent navigability. Further subgroupanalyses will be presented at the meeting. CONCLUSIONS: Preliminary analysis demonstrates favourable reperfusionand safety outcomeswith the MillipedeSystem. The consistency of results across diverse sites may highlightdesign advantages, including straightforward use and reliable navigability. These findingssupportits potential as an effective aspiration‐first approach in large vessel occlusion stroke.