Federico Bolognini1, Pablo A Lebedinsky1, Mariano Musacchio1, Mariette Delaitre1, Abdoulaye M Traoré1, Francis Vuillemet2, François Sellal2, Jean-François Cerfon3, Eric Schluck4, Daniela Iancu5, Elena A Cora6, Sébastien Richard7, René Anxionnat8, Benjamin Gory8, Stephanos N Finitsis9. 1. Department of Diagnostic and Interventional Neuroradiology, Hôpitaux Civils de Colmar, Colmar, France. 2. Department of Neurology, Hôpitaux Civils de Colmar, Colmar, France. 3. Department of Anesthesia and Intensive Care, Hôpitaux Civils de Colmar, Colmar, France. 4. Department of Neurology, Emile Muller Hospital, Mulhouse, France. 5. Department of Radiology, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada. 6. Division of Diagnostic Radiology, Dalhousie University, QEII Health Sciences Centre, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada. 7. Department of Neurology, Stroke Unit, CHRU-Nancy, Université de Lorraine, Nancy, France; INSERM U1116, CHRU-Nancy, Nancy, France. 8. Department of Diagnostic and Therapeutic Neuroradiology, CHRU-Nancy, Université de Lorraine, Nancy, France; Université de Lorraine, IADI, INSERM U1254, Nancy, France. 9. Department of Neuroradiology, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Abstract
BACKGROUND AND PURPOSE: Direct aspiration (DA) using large-bore distal aspiration catheters is an established strategy for the endovascular thrombectomy (EVT) of large-vessel occlusion stroke (LVOS). However, the performance of individual catheters like SOFIA has yet to be examined. METHODS: We present a cohort of 144 consecutive patients treated with first-line DA and SOFIA 6 F Plus catheter for LVOS. We also conducted a systematic review of the literature searching multiple databases for reports on thrombectomy with DA and SOFIA catheters and performed a meta-analysis of recanalization, safety, and clinical outcomes. RESULTS: In the study cohort a successful recanalization (mTICI 2b-3) rate of 75.7% was achieved with DA alone, the global rate for functional independence (90-day mRS 0-2) was 40.3%. For the metanalysis we selected nine articles that included a total of 758 patients treated with first-line thrombectomy with the SOFIA catheters. The mTICI 2b-3 rate was 71.6% (95%CI, 66.3-76.5%) while a rescue stent-retriever was used in 24.1% (95%CI, 17.7-31.9%) of cases. The overall mTICI2b-3 rate after DA and rescue therapy was 88.9% (95%CI, 82.6-93.1%). We found a pooled estimate of 45.6% (95%CI, 38.6-52.8%) for functional independence, a mortality within 90 days of 19% (95%CI, 14.1-25.0%) and a rate of 5.8% (95%CI, 4.2-8.0%) of symptomatic intracranial hemorrhage. CONCLUSION: The DA approach for LVOS with the SOFIA catheters is highly effective with an efficacy and safety profile comparable to those found in contemporary thrombectomy trials and observational studies that use other devices or approaches.
BACKGROUND AND PURPOSE: Direct aspiration (DA) using large-bore distal aspiration catheters is an established strategy for the endovascular thrombectomy (EVT) of large-vessel occlusion stroke (LVOS). However, the performance of individual catheters like SOFIA has yet to be examined. METHODS: We present a cohort of 144 consecutive patients treated with first-line DA and SOFIA 6 F Plus catheter for LVOS. We also conducted a systematic review of the literature searching multiple databases for reports on thrombectomy with DA and SOFIA catheters and performed a meta-analysis of recanalization, safety, and clinical outcomes. RESULTS: In the study cohort a successful recanalization (mTICI 2b-3) rate of 75.7% was achieved with DA alone, the global rate for functional independence (90-day mRS 0-2) was 40.3%. For the metanalysis we selected nine articles that included a total of 758 patients treated with first-line thrombectomy with the SOFIA catheters. The mTICI 2b-3 rate was 71.6% (95%CI, 66.3-76.5%) while a rescue stent-retriever was used in 24.1% (95%CI, 17.7-31.9%) of cases. The overall mTICI2b-3 rate after DA and rescue therapy was 88.9% (95%CI, 82.6-93.1%). We found a pooled estimate of 45.6% (95%CI, 38.6-52.8%) for functional independence, a mortality within 90 days of 19% (95%CI, 14.1-25.0%) and a rate of 5.8% (95%CI, 4.2-8.0%) of symptomatic intracranial hemorrhage. CONCLUSION: The DA approach for LVOS with the SOFIA catheters is highly effective with an efficacy and safety profile comparable to those found in contemporary thrombectomy trials and observational studies that use other devices or approaches.
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