Contact Aspiration Alone or Combined With Stent Retriever Thrombectomy for Middle Cerebral Artery Large Vessel Occlusion

BACKGROUND AND PURPOSE: The effectiveness of a large-bore aspiration catheter for contact aspiration (CA) thrombectomy is compared to the combined use of an aspiration catheter and a stent retriever (CA+SR) for large vessel occlusion (LVO). We assessed the efficacy and safety of CA alone versus CA+S...

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Detalles Bibliográficos
Autores: Navia, Pedro, Fernandez-Prieto, Andres, Alvarez-Muelas, Alberto, Calleja Bonilla, Ángel, Ortega-Castro, Joaquin, Domínguez, Carlos, Sagredo, Antonio, Rodríguez-Benítez, Amado, García-Villanego, Juan, Martínez-Calvo, Alberto, Cubillo-Prieto, Daniel, de la Rosa, Carmen, Mosqueira, Antonio, Bermejo-Garcés, Rebeca, Chaviano, Juan, Bermúdez-Coronel, Isabel, Pérez-García, Carlos, Rodriguez-Paz, Carlos Manuel, Hidalgo-Barranco, Carlos, Maynar, Javier, Caniego, Jose Luis, Molina-Nuevo, Juan David, Maestro, Víctor, Sanchís-García, Juan Manuel, Balboa, Oscar, Martínez-Galdamez, Mario, Garmendia, Eñaut, Comas-Cufí, Marc, Puig, Josep, Zamarro, Joaquín
Tipo de recurso: artículo
Fecha de publicación:2025
País:España
Institución:Conselleria de Salut i Consum del Govern de les Illes Balears
Repositorio:Docusalut
Idioma:inglés
OAI Identifier:oai:docusalut.com:20.500.13003/25451
Acceso en línea:https://hdl.handle.net/20.500.13003/25451
Access Level:acceso abierto
Palabra clave:Stroke
Thrombectomy
Accidente Cerebrovascular
Trombectomía
aspiration
occlusion
outcome
stent retriever
stroke
thrombectomy
Descripción
Sumario:BACKGROUND AND PURPOSE: The effectiveness of a large-bore aspiration catheter for contact aspiration (CA) thrombectomy is compared to the combined use of an aspiration catheter and a stent retriever (CA+SR) for large vessel occlusion (LVO). We assessed the efficacy and safety of CA alone versus CA+SR as first-line treatment for middle cerebral artery (MCA) LVO in daily practice. METHODS: We retrospectively analyzed data from the SARA-3 registry of patients with MCA occlusion (M1 and M2 segments), dividing them into two groups: first-line CA alone and combined CA+SR. Demographic, clinical, angiographic, and clinical outcomes (National Institute of Health Stroke Scale score at 24 h and modified Rankin Scale [mRS] score at 3 months) were compared. RESULTS: Of 551 patients, 348 (63.8%) received CA alone and 203 (36.8%) received CA+SR. The groin-to-reperfusion time was significantly shorter in the CA-alone group than in the combined CA+SR group (median, 26 vs. 40 min, p < 0.001). The CA group demonstrated higher first-pass modified Thrombolysis In Cerebral Infarction (mTICI) 3 recanalization rates (47% vs. 37%; adjusted odds ratio [OR] 1.5 [confidence interval 1-2.1], p = 0.042), a higher final mTICI 3 rate (65% vs. 56%; OR 1.5 [1-2.2], p = 0.037), and fewer new territory embolisms (0.9% vs. 3.9%; OR 0.2 [0-0.8], p = 0.028) compared to the CA+SR group. The CA-alone group had better functional outcomes at 3 months (mRS ≤ 2, 77% vs. 63%; OR 1.9 [1.3-3], p = 0.003). CONCLUSIONS: CA alone outperformed CA+SR as a first-line treatment for MCA LVO, yielding higher first-pass and final recanalization rates, lower new territory embolism risk, shorter procedure times, and better functional outcomes at 3 months.

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