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Comparison Between Three Commonly Used Large-Bore Aspiration Catheters in Terms of Successful Recanalization and First-Passage Effect

2020; Elsevier BV; Volume: 30; Issue: 3 Linguagem: Inglês

10.1016/j.jstrokecerebrovasdis.2020.105566

1532-8511

Vittorio Semeraro, Iacopo Valente, Pietro Trombatore, Maria Porzia Ganimede, Alessandra Briatico, Carmine Di Stasi, Nicola Burdi, Giovanni Boero, Maria Pia Prontera, Prof Roberto Gandini, Sofia Vidali, Marina Diomedi, Fabrizio Sallustio, Francesco D’Argento, Andrea Alexandre, Andrea M. Romi, Alessandro Pedicelli, Alfredo Berardelli, Emilio Lozupone,

Stroke Rehabilitation and Recovery

Objectives To compare three commonly used large-bore aspiration catheters in terms of final successful recanalization rate and first-passage successful and complete recanalization rates (the so called "first-passage effect"). Materials and methods it is an observational retrospective multicenter study conducted in three Italian high-volume tertiary stroke centers between January 2017 and May 2019. The study population included all consecutive patients with an ischemic stroke due to middle cerebral artery occlusion (M1 segment only) that underwent intra-arterial mechanical thrombectomy with contact aspiration as first-line strategy within 24 hours from symptoms onset. Results Three hundred twenty-one patients were included in the study. Multivariable logistic regression analysis comparing the three catheters revealed no differences in terms of successful recanalization. Sofia 6 Plus catheter was associated with better first-passage successful recanalization [OR, 9.09; 95% CI, 2.66–31.03] (p<0.001) and first-passage complete recanalization [OR: 3.73; 95% CI: 1.43-9.72] (p=0.007) whereas rt-PA was associated with worse first-passage recanalization [OR: 0.52; 95% CI: 0.29–0.93] (p=0.028). Conclusions No differences between the three catheters were reported in terms of successful recanalization. Sofia 6 Plus has proven to be superior in achieving both successful and complete first-passage recanalization. Conversely, rt-PA was found to be a negative predicting factor of first-passage effect.