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Comparison Between Three Commonly Used Large-Bore Aspiration Catheters in Terms of Successful Recanalization and
Vittorio Semeraro1, Iacopo Valente2, Pietro Trombatore3
1Ospedale Santissima Annunziata, Dipartimento di Diagnostica per Immagini e Radioterapia, Taranto, Italy.
Insights
The Sofia 6 Plus catheter demonstrated superior first-passage recanalization in stroke thrombectomy. No significant differences were found in overall successful recanalization rates among the tested aspiration catheters.
Area of Science:
- Neurology
- Interventional Neuroradiology
- Vascular Surgery
Background:
- Mechanical thrombectomy is a key treatment for acute ischemic stroke.
- Large-bore aspiration catheters are crucial for effective clot retrieval.
- Optimizing first-pass recanalization is essential to improve patient outcomes.
Purpose of the Study:
- To compare the efficacy of three large-bore aspiration catheters in mechanical thrombectomy.
- To evaluate final successful recanalization rates.
- To assess first-passage successful and complete recanalization rates, termed the 'first-passage effect'.
Main Methods:
- Retrospective, multicenter observational study (January 2017 - May 2019).
- Inclusion of consecutive patients with middle cerebral artery (M1 segment) ischemic stroke undergoing mechanical thrombectomy.
- Contact aspiration as the first-line strategy within 24 hours of symptom onset.
Main Results:
- 321 patients were analyzed.
- No significant differences in overall successful recanalization rates among the three catheters.
- Sofia 6 Plus catheter showed significantly better first-passage successful recanalization (OR, 9.09) and first-passage complete recanalization (OR: 3.73).
- rt-PA administration was associated with worse first-passage recanalization (OR: 0.52).
Conclusions:
- No significant differences exist between the three aspiration catheters for overall successful recanalization.
- The Sofia 6 Plus catheter is superior for achieving both successful and complete first-passage recanalization.
- rt-PA is a negative predictor for the first-passage effect in this cohort.
Objectives:
To compare three commonly used large-bore aspiration catheters in terms of final successful recanalization rate and first-passage successful and complete recanalization rates (the so called "first-passage effect").
Materials And Methods:
it is an observational retrospective multicenter study conducted in three Italian high-volume tertiary stroke centers between January 2017 and May 2019. The study population included all consecutive patients with an ischemic stroke due to middle cerebral artery occlusion (M1 segment only) that underwent intra-arterial mechanical thrombectomy with contact aspiration as first-line strategy within 24 hours from symptoms onset.
Results:
Three hundred twenty-one patients were included in the study. Multivariable logistic regression analysis comparing the three catheters revealed no differences in terms of successful recanalization. Sofia 6 Plus catheter was associated with better first-passage successful recanalization [OR, 9.09; 95% CI, 2.66-31.03] (p<0.001) and first-passage complete recanalization [OR: 3.73; 95% CI: 1.43-9.72] (p=0.007) whereas rt-PA was associated with worse first-passage recanalization [OR: 0.52; 95% CI: 0.29-0.93] (p=0.028).
Conclusions:
No differences between the three catheters were reported in terms of successful recanalization. Sofia 6 Plus has proven to be superior in achieving both successful and complete first-passage recanalization. Conversely, rt-PA was found to be a negative predicting factor of first-passage effect.
