Large-bore aspiration catheter selection does not influence reperfusion or outcome after manual aspiration thrombectomy. (7th February 2019)

• Record Type: Journal Article
• Authors: Tonetti, Daniel A; Desai, Shashvat M; Casillo, Stephanie; Zussman, Benjamin M; Brown, Merritt W; Jadhav, Ashutosh P; Jankowitz, Brian Thomas; Jovin, Tudor G; Gross, Bradley A
• Is Part Of: Journal of neurointerventional surgery. Volume 11:Number 7(2019)
• Page Start: 637
• Page End: 640
• Publication Date: 2019-02-07
• Subjects: stroke -- thrombectomy -- catheter; Nervous system -- Surgery -- Periodicals; Cerebrovascular disease -- Surgery -- Periodicals; 617.48
• DOI: 10.1136/neurintsurg-2018-014633
• Languages: English
• ISSNs: 1759-8478

Abstract

Abstract : Introduction: Various large-bore catheters can be employed for manual aspiration thrombectomy (MAT); clinical differences are rarely explored. Methods: Prospectively collected demographic, angiographic, and clinical data for patients with acute internal carotid artery, middle cerebral artery M1, or basilar occlusions undergoing MAT over 23 months at a comprehensive stroke center were reviewed. We excluded patients in stentriever-based randomized trials/registries. The four most commonly utilized aspiration catheters were analyzed, and multivariate logistic regression analyses were performed to determine the effect of primary aspiration catheter choice on first-pass success, final reperfusion, and modified Rankin Scale (mRS) score at 90 days. Results: Of 464 large vessel thrombectomies, 180 were performed via MAT on the first pass with one of four catheters. First-pass success was achieved in 42% of cases overall; this rate did not differ significantly between catheters: 50% for Sofia, 45% for CAT6, 40% for 0.072 inch Navien, and 36% for ACE68, p=0.67. Final Thrombolysis in Cerebral Infarction 2b or 3 reperfusion was achieved in 94% of cases overall: 97% of cases with CAT6, 95% with Sofia, 92% with Navien, and 92% with ACE68, p=0.70. Mean number of passes for index thrombus (2.0 overall), median procedure time (32 min overall), 90-day good outcome (mRS 0–2, mean 36%), and 90-day mortality (mean 27%) did not differ significantly between patients treated with different initial catheters. Conclusion: Among large-bore aspiration catheters, catheter selection is not an independent predictor of first-pass success, final reperfusion, or clinical outcome.