• Bradley A Gross, Joseph S Hudson, Daniel A Tonetti, Shashvat M Desai, Michael J Lang, Ashutosh P Jadhav, Brian T Jankowitz, and Tudor G Jovin.
• Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
• Neurosurgery. 2021 Mar 15; 88 (4): 758-762.

BackgroundWhile multiple new larger-bore aspiration catheters have been introduced for stroke thrombectomy, sizeable cohort outcome studies are lacking along with meaningful comparative studies to evaluate whether they represent a clinically relevant improvement compared to predecessors.ObjectiveTo evaluate comparative angiographic and clinical outcomes between an 071 and 068 aspiration catheter.MethodsThe authors reviewed an institutional thrombectomy database extracting the first 150 consecutive cases utilizing React 71 (Medtronic, Dublin, Ireland) with a comparison of background/demographic, procedural, angiographic, and clinical outcome variables to a cohort of patients treated with our previously most frequently utilized 0.068-inch aspiration catheter.ResultsIn our React 71 cohort, successful reperfusion (thrombolysis in cerebral infarction [TICI] 2b-3) was achieved in 95% of cases. In comparison to a prior cohort of 96 patients treated with a 0.068-inch catheter, there was no statistically significant difference in rates of successful reperfusion (TICI 2b-3), initial disposition, and 90-d outcome. However, the frequency of single pass cases was significantly higher in the React 71 cohort (47% vs 35%, P = .019 on multivariate analysis) along with the rate of TICI 2c-3 reperfusion after the first pass (26% vs 14%, P = .019 on multivariate analysis), and final TICI 2c-3 reperfusion (39% vs 28%, P = .04 on multivariate analysis).ConclusionWhile rates of TICI 2b-3 reperfusion and clinical outcome results were similar, our study suggests that a newer, larger bore aspiration catheter may be associated with a greater frequency of single pass cases and higher quality reperfusion, judged as TICI 2c-3 frequency after the first and final pass.© Congress of Neurological Surgeons 2020.

24 keywords...

hide…