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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Detalhes bibliográficos
Autores: Navia, Pedro, Fernandez-Prieto, Andres, Alvarez-Muelas, Alberto, Calleja, 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
Formato: artículo
Fecha de publicación:2025
País:España
Recursos:Conselleria de Salut i Consum del Govern de les Illes Balears
Repositorio:Docusalut
Idioma:inglés
OAI Identifier:oai:docusalut.com:20.500.13003/25266
Acesso em linha:https://hdl.handle.net/20.500.13003/25266
Access Level:acceso abierto
Palavra-chave:Aged
Aged, 80 and over
Combined Modality Therapy
Female
Humans
Infarction, Middle Cerebral Artery* / diagnostic imaging
Infarction, Middle Cerebral Artery* / surgery
Infarction, Middle Cerebral Artery* / therapy
Male
Middle Aged
Registries
Retrospective Studies
Stents*
Suction
Thrombectomy* / instrumentation
Thrombectomy* / methods
Treatment Outcome
Anciano
Terapia Combinada
Femenino
Humanos
Masculino
Persona de Mediana Edad
Sistema de Registros
Estudios Retrospectivos
Succión
Resultado del Tratamiento
aspiration
occlusion
outcome
stent retriever
stroke
thrombectomy
Descrição
Resumo: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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