Abstract / Summary
Mechanical thrombectomy has become the standard treatment for acute ischemic stroke caused by large vessel occlusion. Aspiration thrombectomy has evolved substantially over the past decade; however, conventional large-bore aspiration catheters (inner diameter ≥0.068″) may be limited by incomplete clot ingestion, distal embolization, and dependence on adjunctive devices such as balloon guide catheters to achieve proximal flow arrest. Superbore aspiration catheters, typically defined by an inner diameter ≥0.080 inches, are the most recent technological advancement in aspiration thrombectomy. Superbore catheters have the ability to navigate to the M1 segment of the middle cerebral artery, facilitating local flow control, complete clot ingestion, and distal flow reversal during aspiration. Since 2020, several superbore systems have been developed, including Zoom 88 (Imperative Care), HiPoint 88 (Route 92 Medical), Millipede88 (Perfuze), SOFIA 88 (Terumo), Broadway 8 (Stryker Neurovascular), and Cereglide 92 (Johnson & Johnson MedTech). Early clinical studies suggest that superbore catheters may improve first-pass effect and final reperfusion rates compared with standard aspiration thrombectomy devices, while maintaining an acceptable safety profile. This review summarizes the design characteristics, clinical evidence, and procedural considerations associated with currently available superbore systems. Although preliminary data are promising, further randomized clinical trials are needed to determine the optimal role of superbore aspiration in large vessel occlusion treatment.