Distal thrombectomy for acute ischemic stroke: Is a 0.008-inch wire a safer alternative?

Distal thrombectomy for acute ischemic stroke: Is a 0.008-inch wire a safer alternative? | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Distal thrombectomy for acute ischemic stroke: Is a 0.008-inch wire a safer alternative? Yilmaz Onal, Volga Ulas Ercan, Ahmet Gunkan, Umut Ergul, Oyku Sur, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7357469/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 23 Jan, 2026 Read the published version in Neurosurgical Review → Version 1 posted 6 You are reading this latest preprint version Abstract Background: Distal medium vessel occlusion (DMVO) thrombectomy remains challenging due to anatomical constraints and procedural risks. We evaluated the efficacy and safety of using a 0.008-inch J-shaped microguidewire in acute ischemic stroke (AIS) patients with DMVO. Methods: We retrospectively analyzed AIS patients who underwent DMVO thrombectomy using a 0.008-inch J-shaped microguidewire at a high-volume stroke center in 2024. Baseline characteristics, National Institutes of Health Stroke Scale (NIHSS), IV-tPA administration, occlusion location, and procedural complications were recorded. Successful recanalization was defined as modified Thrombolysis in Cerebral Infarction (mTICI) 2c–3, while good clinical outcome was defined as a modified Rankin Scale (mRS) score of ≤2 at 90 days. Results: Among 441 AIS patients treated with thrombectomy in 2024, 84 had DMVO, and 32 consecutive patients met the inclusion criteria (mean age 75±12 years, range 32–93). Primary DMVO was identified in 19 cases, while 13 had secondary DMVO following proximal thrombectomy. The mean NIHSS was 11±3.4 (range 7–21). The occlusion sites were M2 (n=21), A3 (n=6), M3 (n=4), P2 (n=2), and M4 (n=1) segments. Successful recanalization was achieved in 90.6% (n=29), with one patient requiring rescue stenting. No guidewire-related complications occurred. Symptomatic intracranial hemorrhage was observed in 6.3% (n=2), one of whom underwent decompression. The rate of good clinical outcomes was 53.1%, and 3 patients (9.3%) died. Conclusions: Neurointerventionalists are looking for better techniques to reduce the risks associated with distal thrombectomy. Our findings suggest that using a 0.008-inch J-shaped microguidewire may enhance procedural safety and success in DMVO. Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 23 Jan, 2026 Read the published version in Neurosurgical Review → Version 1 posted Reviews received at journal 10 Oct, 2025 Reviewers agreed at journal 10 Oct, 2025 Reviewers invited by journal 08 Oct, 2025 Editor assigned by journal 08 Oct, 2025 Submission checks completed at journal 14 Aug, 2025 First submitted to journal 12 Aug, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7357469","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":531741245,"identity":"865cf0c7-d2f1-4c14-8229-e0fc8ee6eddb","order_by":0,"name":"Yilmaz 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We evaluated the efficacy and safety of using a 0.008-inch J-shaped microguidewire in acute ischemic stroke (AIS) patients with DMVO.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eWe retrospectively analyzed AIS patients who underwent DMVO thrombectomy using a 0.008-inch J-shaped microguidewire at a high-volume stroke center in 2024. Baseline characteristics, National Institutes of Health Stroke Scale (NIHSS), IV-tPA administration, occlusion location, and procedural complications were recorded. Successful recanalization was defined as modified Thrombolysis in Cerebral Infarction (mTICI) 2c–3, while good clinical outcome was defined as a modified Rankin Scale (mRS) score of ≤2 at 90 days.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003e\u0026nbsp;Among 441 AIS patients treated with thrombectomy in 2024, 84 had DMVO, and 32 consecutive patients met the inclusion criteria (mean age 75±12 years, range 32–93). Primary DMVO was identified in 19 cases, while 13 had secondary DMVO following proximal thrombectomy. The mean NIHSS was 11±3.4 (range 7–21). The occlusion sites were M2 (n=21), A3 (n=6), M3 (n=4), P2 (n=2), and M4 (n=1) segments. Successful recanalization was achieved in 90.6% (n=29), with one patient requiring rescue stenting. No guidewire-related complications occurred. Symptomatic intracranial hemorrhage was observed in 6.3% (n=2), one of whom underwent decompression. The rate of good clinical outcomes was 53.1%, and 3 patients (9.3%) died.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e Neurointerventionalists are looking for better techniques to reduce the risks associated with distal thrombectomy. 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