Millipede Aspiration for Revascularization in Stroke (MARRS): prospective trial of a novel 0.088 inch corrugated catheter
Year: 2026
Type: article
Study design: Clinical Trial
Abstract: BACKGROUND: The Millipede AspiRation for Revascularization in Stroke (MARRS) pivotal study was a prospective, multicenter, single arm trial evaluating the safety and efficacy of the corrugated Millipede catheter system in patients with acute ischemic stroke due to large vessel occlusion. METHODS: Patients aged 18-85 years with internal carotid artery, M1, M2, or basilar artery occlusions treatable within 8 hours were eligible. Catheter selection was based on target vessel diameter (Millipede88 >2.7 mm; Millipede70 >2.2 mm). The primary efficacy endpoint was modified Thrombolysis in Cerebral Infarction (mTICI) ≥2b within ≤3 passes without rescue therapy. Imaging and clinical outcomes were independently adjudicated. Secondary endpoints included first pass effect (mTICI ≥2c). RESULTS: 180 patients were treated (57% US, 43% EU). Median age was 69 years, mean baseline National Institutes of Health Stroke Scale score was 17, and median Alberta Stroke Program Early CT Score was 9. M1 occlusion was the most common target lesion (62%). The primary endpoint was achieved in 160/180 patients (88.9%; 95% CI lower bound 84.3%) in the intention-to-treat cohort. Direct first pass aspiration was performed with Millipede88 and Millipede70 in 64% and 36% of patients, respectively. Navigation success was 96% with Millipede88 and 99% with Millipede70. Among Millipede88 patients, first pass mTICI ≥2c was achieved in 60%, increasing to 75% in the M1 subgroup. Final mTICI ≥2c was achieved in 85% of primary Millipede88 cases. Symptomatic intracranial hemorrhage occurred in 2.3%, intracranial dissection in 1.1%, no perforations occurred, and 90 day all cause mortality was 13.9%. CONCLUSIONS: The Millipede aspiration system demonstrated excellent deliverability and high rates of first pass and final mTICI ≥2c, particularly in M1 occlusions, with low rates of adverse events. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov NCT05714501.
Authors: Raul G Nogueira, Manuel Requena, Jaydevsinh Dolia, Syed Zaidi, Pedro Navia, Gaultier Marnat, Tarun Bhalla, Alhamza R Al-Bayati, Michael Nahhas, Osama O Zaidat, Ryan Priest, Romain Bourcier, Waldo R Guerrero, Reza Dashti, Gregory Gascou, Raoul Pop, Tareq Kass-Hout, Nitin Goyal, Amin Aghaebrahim, Adnan I Qureshi, Sameer A Ansari, Guilherme Dabus, Jose I Suarez, Levansri D Makalanda, Alberto Alvarez-Muelas, Xavier Barreau, Matthew T Bender, Mouhammad Jumaa, Eugene Lin, Guillaume Bellanger, Francesco Diana, Ryan Hebert, Sunil A Sheth, Richard Burgess, Diogo C Haussen, Charles Matouk, Christophe Cognard, Ameer E Hassan, Ricardo A Hanel, Benjamin Gory, Marc Ribo
Institutions: UPMC Health System, University of Pittsburgh Medical Center, Vall d'Hebron Hospital Universitari, Grady Memorial Hospital, Emory University, ProMedica Toledo Hospital, University of Toledo, Hospital Universitario La Paz, Centre Hospitalier Universitaire de Bordeaux, Hôpital Pellegrin, University of Rochester Medicine, University of Rochester, The University of Texas Health Science Center at Houston, Mercy St. Vincent Medical Center, Bon Secours Mercy Health, Oregon Health & Science University, Centre Hospitalier Universitaire de Nantes, University of South Florida, Stony Brook University, Centre Hospitalier Universitaire de Montpellier, Hôpitaux Universitaires de Strasbourg, University of Chicago, Semmes Murphey Foundation, Baptist Medical Center Jacksonville, University of Missouri, Northwestern University, Baptist Hospital of Miami, Johns Hopkins University, Johns Hopkins Medicine, Royal London Hospital, Hôpital Purpan, Yale University, Valley Baptist Medical Center, Inserm, Centre Hospitalier Régional et Universitaire de Nancy, Imagerie Adaptative Diagnostique et Interventionnelle, Université de Lorraine
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7204470324