Raul Nogueira, MD, discusses the latest research and innovation in super-bore catheters for the treatment of AIS and the preliminary results from the MARRS pivotal trial in an interview with SmartTRAK.
In an interview with SmartTRAK, Raul Nogueira, MD, interventional and stroke neurologist at the University of Pittsburgh and chief of cerebrovascular medicine at the UPMC Stroke Institute, discusses the latest research and innovation in super-bore catheters for the treatment of acute ischemic stroke (AIS), including preliminary results from the MARRS pivotal trial that he recently presented at the Society of NeuroInterventional Surgery (SNIS) 2025 Annual Meeting in Nashville, TN.
Dr. Nogueira highlights key results from the MARRS pivotal trial, which is evaluating Perfuze Medical’s Millipede super-bore 088 catheter, how the results compare to other super-bore pivotal trials and what factors contributed to MARRS’ high first-pass effect rate.
Listen to the interview below (43:20 min) to learn more, including how Millipede performed in different parts of the brain and the status of research and innovation that is helping to drive growth in the US Market for Mechanical Thrombectomy. A link to download a full transcript of the interview is also provided below.
Interview by Timecode
00:06 Introduction, background about stroke thrombectomy and the evolution of technology and research in mechanical thrombectomy devices.
10:27 Discussion about the MARRS pivotal trial vs other trials and what contributed to the the high, first-pass effect rate.
18:44 Different studies use different definitions of first-pass effect and good reperfusion. Where does the MARRS study definition fit and compare to how other studies define good reperfusion?
21:47 Discussion about safety data for super-bore catheters vs the Millipede catheter, device designs and comparison to other types of thrombectomy devices.
23:34 MARRS enrolled a broad range of occlusions. How did Millipede perform in different locations, including distal M2 vessels and challenging posterior occlusions? How do these data fit in the broader context of the DISTAL Trial which found similar outcomes for mechanical thrombectomy with standard care vs standard care alone?
28:29 For super-bore catheters, there are now results from the Imperative Trial, SUMMIT MAX, MARRS and Terumo’s real-world study, etc. What other data are needed to establish super-bore catheters? When will the final results of the MARRS study be available, including patient outcomes?
33:33 Is bigger necessarily better? Super-bore catheters vs smaller aspiration catheters with computer-assisted suction. An ongoing debate.
38:14 First-pass effect with aspiration and opportunities for innovation.
39:55 Beyond mechanical thrombectomy, what is the next major paradigm shift in interventional stroke care? The future of stroke intervention, including adjunctive pharmacology, robotics, nanotechnologies, endogenous thrombolytics, adjunctive lytics, etc.
Want to learn more about super-bore catheters and the treatment of acute ischemic stroke? Click the button below to download and read the complete transcript of SmartTRAK's interview with Raul Nogueira, MD, conducted by Anne Staylor, Executive Editor, VP & GM of Neuro Therapies.
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