Efficacy of Mechanical Thrombectomy using Penumbra ACETM Aspiration Catheter Compared to Stent Retriever SolitaireTM FR in Patients with Acute Ischemic Stroke

Abstract

Background: Mechanical thrombectomy is the standard therapy in patients with acute ischemic stroke (AIS). The primary aim of our study was to compare the procedural efficacy of the direct aspiration technique, using Penumbra ACETM aspiration catheter, and the stent retriever technique, with a SolitaireTM FR stent. Secondarily, we investigated treatment-dependent and treatment-independent factors that predict a good clinical outcome. Methods: We analyzed our series of mechanical thrombectomies using a SolitaireTM FR stent and a Penumbra ACETM catheter. The clinical and radiographic data of 76 patients were retrospectively reviewed. Using binary logistic regression, we looked for the predictors of a good clinical outcome. Results: In the Penumbra ACETM group we achieved significantly higher rates of complete vessel recanalization with lower device passage counts, shorter recanalization times, shorter procedure times and shorter fluoroscopy times (p < 0.001) compared to the SolitaireTM FR group. We observed no significant difference in good clinical outcomes (52.4% vs. 56.4%, p = 0.756). Predictors of a good clinical outcome were lower initial NIHSS scores, pial arterial collateralization on admission head CT angiography scan, shorter recanalization times and device passage counts. Conclusions: The aspiration technique using Penumbra ACETM catheter is comparable to the stent retriever technique with SolitaireTM FR regarding clinical outcomes.

Effect of Solitaire FR Stent Thrombectomy Combined with the Suction Thrombus on the Clinical Effect and Prognosis of Acute Middle Cerebral Artery Occlusion

“…Stop pushing and confirm the cause of obstruction. Forced pushing may damage the device or vessels [ 13 ]. It is worth noting that after the stent is released, it should be kept in place for 5 minutes to open the occluded artery, which can quickly supply blood to the distal end and improve ischemic tolerance.…”

The Good Clinical Outcome for Patients with Acute Ischemic Stroke Treated with Mechanical Thrombectomy—Does Time Still Matter?

“…In both KSOT and USOT groups, we identified the presentation of the pial arterial collateralization in the CT angiography scan at admission as the factor predicting a good clinical outcome. The presentation of the pial arterial collaterals on the CT angiography scan at admission in cases of successful vessel recanalization could be crucial for a good clinical outcome [24][25][26][27][28][29].…”

Updates in mechanical thrombectomy

“…The penumbra pivotal stroke trial demonstrated safe use up to 8 h from stroke onset and an 82% recanalization rate in 125 patients [45]. This aspiration device shows similar clinical outcomes to the Solitaire FR stent retriever in a retrospective review of 76 patients [46]. However, it demonstrated higher rates of complete recanalization with lower device passage count, shorter procedure times, and shorter recanalization times [46][47][48][49][50].…”

“…This aspiration device shows similar clinical outcomes to the Solitaire FR stent retriever in a retrospective review of 76 patients [ 46 ]. However, it demonstrated higher rates of complete recanalization with lower device passage count, shorter procedure times, and shorter recanalization times [ 46 - 50 ].…”