Super-Bore Aspiration Catheters (≥ 0.088″) in Acute Ischemic Stroke: a Systematic Review and Meta-analysis

Super-bore aspiration catheters with an inner diameter ≥ 0.088 inches have been developed to enhance clot ingestion, improve first-pass reperfusion, and reduce the need for adjunctive thrombectomy techniques in acute ischemic stroke. A comprehensive synthesis of their technical performance, angiographic efficacy, and safety profile is lacking.

A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. MEDLINE, Web of Science, and Scopus were searched from inception through December 7, 2025. Eligible studies included patients with acute ischemic stroke treated with super-bore aspiration catheters (inner diameter ≥ 0.088 inches). Pooled estimates were calculated using random-effects models.

Eleven studies comprising 835 patients were included. Successful delivery of the aspiration catheter to the target clot was achieved in 90.4% of cases (95% CI 84.82-94.13). Cross-over to stent retriever occurred in 11.95% (95% CI 4.89-26.37), and rescue therapy was required in 12.60% (95% CI 5.61-25.91). First pass effect (mTICI 2c-3) was achieved in 55.91% (95% CI 48.42-63.14), while modified first pass effect (mTICI ≥ 2b) occurred in 68.61% (95% CI 60.80-75.49). Final successful reperfusion (mTICI ≥ 2b) was achieved in 97.71% (95% CI 93.37-99.23), with near-complete or complete reperfusion (mTICI 2c-3) in 86.71% and complete reperfusion (mTICI 3) in 65.18% of cases. Symptomatic intracranial hemorrhage occurred in 1.93%, embolization to new territory in 1.62%, and total procedural complications in 3.80% of cases. Favorable functional outcome (mRS 0-2 at 90 days) was observed in 50.0%, while overall mortality was 16.87%.

Super-bore aspiration catheters (≥ 0.088 inches) show high technical feasibility, comparable first pass reperfusion rates, and a favorable safety profile in the treatment of acute ischemic stroke.