Thrombectomy using a combined technique with a more flexible aspiration catheter

Currently, many types of aspiration catheters (ACs) are available for thrombectomy. Since few studies have examined the relationship between AC flexibility and clinical outcomes, we retrospectively examined it in patients undergoing first-line thrombectomy using a combined technique (CBT).

Consecutive patients undergoing CBT thrombectomy for stroke at our institution from January 2020 to December 2023 were enrolled in this study. Patients were divided into two groups by the flexibility of the AC used: the more flexible AC (MFAC) group and the non-MFAC group. The primary outcome was a modified Rankin Scale score of 0-2 at 90 days after thrombectomy.

A total of 330 patients were enrolled, with 234 (70.9 %) assigned to the MFAC group and 96 (29.1 %) assigned to the non-MFAC group. The proportion of patients achieving the primary outcome was significantly higher in the MFAC group than in the non-MFAC group (39.7 % vs. 26.0 %, adjusted odds ratio 2.53 [95 % confidence interval 1.34-4.93], p = 0.004). The use of MFACs was associated with higher rates of patients achieving a modified Rankin Scale score of 0-3 at 90 days after thrombectomy, final mTICI 2b-3, final mTICI 2c-3, and first pass mTICI ≥ 2c. It was also associated with lower rates of type 2 parenchymal hematoma and symptomatic intracranial hemorrhage.

CBT thrombectomy with an MFAC may lead to better clinical outcomes, including higher rates of successful recanalization and the first pass effect, as well as fewer type 2 parenchymal hematoma and symptomatic intracranial hemorrhage.