Multicentre AsPiration Large-vessel Evaluation: Canadian registry of RED-78 aspiration catheter (MAPLE-78)

Large-bore aspiration catheters are increasingly used for endovascular stroke treatment (EVT). The Penumbra RED-78 is a novel large-bore aspiration catheter for which no clinical data have been published to date. We aimed to assess the technical success and safety of this device.

We retrospectively collected data on consecutive patients with large-vessel occlusion acute ischemic stroke treated with the RED-78 catheter at six Canadian comprehensive stroke centres between April 2024 and December 2025. The primary endpoint was near-complete or complete reperfusion (eTICI ≥2c). Secondary endpoints included first-pass effect (FPE), puncture-to-recanalization time, and symptomatic intracranial hemorrhage (sICH).

Sixty patients underwent EVT with the RED-78 catheter. Median age was 71 years (IQR 59-78), and 22 (36.7%) were female. The intracranial ICA was the most frequent occlusion site (36/60, 60%). Median vessel diameter at the occlusion site was 3.8 mm (IQR 3.5-4.4), and median clot burden score was 5 (IQR 4-6). Contact aspiration alone was the frontline technique in 47/60 (78.3%). The median number of passes was 2 (IQR 1-2). FPE was achieved in 21/60 patients (35.0%). Final eTICI 2c/3 reperfusion was achieved in 53/60 (88.3%). Median puncture-to-recanalization time was 30 minutes (IQR 20-49). No vessel perforations or device-related complications occurred. sICH was observed in 1/60 patients (1.7%).

In this multicentre experience, the RED-78 catheter achieved high reperfusion rates with a favorable safety profile. These findings support its use as an effective large-bore aspiration device.