Triple Aspiration versus Conventional Aspiration Techniques: A Randomized In Vitro Evaluation

Area of Science:

• Endovascular therapy
• Cerebrovascular disease management
• Interventional neurology

Background:

• Aspiration thrombectomy is a standard treatment for ischemic stroke.
• Single-aspiration maneuvers are common, but multiple cycles may improve outcomes.
• The efficacy of a triple aspiration technique has not been extensively studied.

Purpose of the Study:

• To evaluate the efficacy of a novel
• triple aspiration technique
• in aspiration thrombectomy.
• To compare the triple aspiration technique against single-syringe and continuous pump aspiration.
• To assess outcomes including first-pass efficacy (FPE) and clot removal success.

Main Methods:

• A 3D-printed adult vasculature model was used for benchtop testing.
• Fibrin-rich and red blood cell-rich clots were artificially created.
• Triple aspiration, single aspiration, and pump aspiration techniques were compared in a randomized fashion.

Main Results:

• The triple aspiration technique demonstrated a significantly higher FPE rate (67.6%) compared to single (41.1%) and pump aspiration.
• Complete clot removal was achieved with fewer attempts using triple aspiration (1.2) versus single aspiration (1.8).
• Triple aspiration generated significantly higher vacuum pressures than both single-syringe and pump aspiration.

Conclusions:

• The triple aspiration technique shows promise for improving FPE and vacuum pressure in aspiration thrombectomy.
• Further clinical investigation is warranted to confirm the safety and efficacy of this technique.
• This technique may offer an advantage in achieving successful clot retrieval.