Impact of aspiration catheter size on first-pass effect in the combined use of contact aspiration and stent retriever technique

• DOI: 10.1136/svn-2020-000833
• Publication Date: 2021-03-29T15:10:40Z
• Authors: Carlos Pérez-García; Christian Maegerlein; Santiago Rosati; Charlotte Rüther; Carlos Gómez-Esca...; Claus Zimmer; Juan Arrazola; Maria Teresa Berndt; Manuel Moreu
• Keywords: Stroke

Background and purpose The first-pass effect (FPE), defined as a Expanded Treatment in Cerebral Ischaemia (eTICI) 2c/3 reperfusion, has emerged key metric of efficacy mechanical thrombectomy (MT) for acute ischaemic stroke. proximal balloon occlusion together with direct thrombus aspiration during stent retriever (PROTECT)-PLUS technique consists the use guide catheter combined MT approach involving contact retriever. aim this study is to assess effectiveness safety PROTECT-PLUS using distal catheters (DACs) different inner diameters by comparing large-bore DAC Catalyst 7 versus medium-bore DACs. Methods Retrospective analysis prospectively maintained database patients treated 7, 6 or 5 an either terminal carotid artery M1 M2 segments middle cerebral from 2018 2020 two comprehensive stroke centres. Baseline characteristics procedural, clinical outcomes were compared between groups. Multivariable logistic regression was performed order find independent predictors FPE. Results We identified 238 consecutive front-line (n=86), (n=78) (n=76). rate FPE higher (54%) than (33%, p=0.009) (32%, p=0.005), addition final eTICI reperfusion rates, shorter procedural times, lower need rescue therapy fewer procedure-related complications. After multivariable sole factor associated (OR 2.34; 95% CI 1.19 4.58; p=0.014). Conclusion Further development incorporating larger-bore procedure while reducing complication rates.