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Introduction Large bore aspiration thrombectomy is becoming more common for treatment of large vessel occlusion (LVO) stroke. The SOFIA 88 Neurovascular Aspiration Catheter (Terumo Neurovascular) is an advanced large-bore device with a 0.088″ inner diameter, with a soft distal tip to enhance distal vessel access and improve clot interface during aspiration. We present a multicenter retrospective experience evaluating its trackability, efficacy, and safety during limited premarket release in the United States.Methods A retrospective observational study was performed across three comprehensive stroke centers. All patients who underwent mechanical thrombectomy using the SOFIA 88 for anterior circulation LVO were included. Demographics, procedural details, thrombolysis use, angiographic outcomes, complications, and neurological outcomes were collected.Results Thirteen patients were treated (mean age 70.9 ± 14.6 years, 8 male). Five patients (38.4%) received IV thrombolytics. Mean admission NIHSS was 18.3 ± 8.1; mean ASPECTS was 8.2 ± 2.0. All cases involved anterior circulation occlusions, including 9 MCA strokes (2 with tandem ICA lesions). An 8F long sheath was used in 92.3% of cases. The SOFIA 88 catheter reached the face of the thrombus in all cases. First-pass aspiration using SOFIA 88 was successful in 9 of 13 cases (69.2%).Adjunctive devices were required in 2 cases (1 stent retriever, 1 distal emboli). TICI ≥2b was achieved without additional devices in 8 patients (72.7%). There were no cases of symptomatic intracranial hemorrhage, dissection, vessel perforation, or vasospasm. Discharge NIHSS improved significantly at discharge to 9.4 ± 7.6 (p = 0.0076). The average procedure time took 16.2 ± 9.2 minutes.Conclusions In this early multicenter experience, the SOFIA 88 demonstrated excellent trackability, a high first-pass success rate, and favorable safety outcomes. In 92 % of cases, no adjunctive devices were needed for recanalization. No device-related complications or hemorrhagic events were observed.Disclosures A. Gajjar: None. A. Custozzo: None.Abstract E-180 Figure 1