Tigertriever Distal Vessels Registry

• Patients who present with acute ischemic stroke, who can be treated within 6 hours of symptoms onset, who are either refractory to or ineligible for IV t-PA treatment and intend to be treated with thrombectomy.
• Patients ≥18
• NIHSS Score of ≥2
• Angiographically confirmed occlusion in a M2 or distal (medium to small) branch that is accessible to the Tigertriever device (17 or 13) as determined by the vessel diameter (≥1mm).
• Anticipated life expectancy of at least 6 months from presentation
• Signed informed consent form by the patient or a legally acceptable representative.

Exclusion Criteria:

• Extended infarct - ischemic changes >1/3 MCA territory / 100 ml tissue or ASPECT score \<5

  • Pre- stroke mRS ≥ 2
  • Unknown time of stroke symptom onset
  • Vessel diameter \< 1mm
  • Angiographically evident extreme vessel tortuosity that may preclude the device from reaching the target area.
  • Occlusion/stenosis proximal to thrombus that precludes safe retrieval
  • Medical co-morbidities including but not limited to:
  • Uncontrolled coagulopathy such as International Normalized Ratio (INR) of > 3.0 or platelets count \< 40 x109/L or APTT >50 sec
  • Serious concurrent medical illness: myocardial infarction, seizures, sepsis, uncontrolled diabetes, uncontrolled hypertension, brain tumor, renal impairment (eGFR \<60).
  • Baseline glucose \< 2.7 or > 22.2 mmol/L

  • Imaging features of:

    • raised intracranial pressure or significant mass effect (for example, midline shift, severe sulcal effacement, transcompartmental herniation)
    • intracranial hemorrhage
    • vascular malformation or aneurysm
    • significant vascular abnormality such as carotid dissection, complete carotid occlusion or large/medium vessel vasculitis
  • Allergy/sensitivity to nickel-titanium or contrast media
  • Females who are pregnant or lactating
  • Unable to obtain informed consent from the patient or a suitable legal representative
  • Any other contraindication to thrombectomy