Bradley A Gross1, Ashutosh P Jadhav2, Tudor G Jovin3, Brian T Jankowitz4. 1. Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA; The Stroke Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. Electronic address: Grossb2@upmc.edu. 2. Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA; The Stroke Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. 3. Department of Neurology, Cooper Health System, Camden, New Jersey, USA. 4. Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA; The Stroke Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Abstract
INTRODUCTION: Three new 0.071-inch and 0.072-inch aspiration catheters have been introduced for stroke thrombectomy. Their comparative efficacy has not been clinically evaluated. METHODS: We reviewed a prospectively maintained thrombectomy database for cases using 1 of these 3 catheters for proximal large vessel occlusion from September 2018 to February 2019. Clinical and angiographic information was extracted. RESULTS: Of 145 thrombectomies performed over the time period, 49 utilized 1 of the 3 new large-bore catheters (React 71, n = 21; Vecta 71, n = 19; Jet 7, n = 9) on the first pass. Mean patient age was 73 years (SD: 15). Mean presenting National Institute of Health Stroke Scale score was 19 (SD: 6, range: 5-33). Clot location was middle cerebral artery first segment in 59% of cases, internal carotid artery in 31%, and basilar in 10%. With or without a stentriever, clot access with the initially selected aspiration catheter was achieved in 47 of 49 (96%) cases. Excluding empiric stentriever usage, the aspiration catheter could be delivered to the clot without needing a stentriever in 87% of cases: 100% with React 71, 93% with Vecta 71, and 43% with Jet 7 (P = 0.002). Final Thrombolysis in Cerebral Infarction score 2b/3 was achieved in 92% of cases overall: 95% with React 71, 89% with Jet 7, and 89% with Vecta 71. Median procedure time was 28 minutes; mean total number of passes was 2.4 (SD: 1.6) with 39% of cases being single-pass cases. These rates did not significantly differ between aspiration catheters. CONCLUSIONS: In comparing the newest large bore aspiration catheters, similar angiographic efficacy is achieved.
INTRODUCTION: Three new 0.071-inch and 0.072-inch aspiration catheters have been introduced for stroke thrombectomy. Their comparative efficacy has not been clinically evaluated. METHODS: We reviewed a prospectively maintained thrombectomy database for cases using 1 of these 3 catheters for proximal large vessel occlusion from September 2018 to February 2019. Clinical and angiographic information was extracted. RESULTS: Of 145 thrombectomies performed over the time period, 49 utilized 1 of the 3 new large-bore catheters (React 71, n = 21; Vecta 71, n = 19; Jet 7, n = 9) on the first pass. Mean patient age was 73 years (SD: 15). Mean presenting National Institute of Health Stroke Scale score was 19 (SD: 6, range: 5-33). Clot location was middle cerebral artery first segment in 59% of cases, internal carotid artery in 31%, and basilar in 10%. With or without a stentriever, clot access with the initially selected aspiration catheter was achieved in 47 of 49 (96%) cases. Excluding empiric stentriever usage, the aspiration catheter could be delivered to the clot without needing a stentriever in 87% of cases: 100% with React 71, 93% with Vecta 71, and 43% with Jet 7 (P = 0.002). Final Thrombolysis in Cerebral Infarction score 2b/3 was achieved in 92% of cases overall: 95% with React 71, 89% with Jet 7, and 89% with Vecta 71. Median procedure time was 28 minutes; mean total number of passes was 2.4 (SD: 1.6) with 39% of cases being single-pass cases. These rates did not significantly differ between aspiration catheters. CONCLUSIONS: In comparing the newest large bore aspiration catheters, similar angiographic efficacy is achieved.