Comparison Between Three Commonly Used Large-Bore Aspiration Catheters in Terms of Successful Recanalization and First-Passage Effect,Journal of Stroke & Cerebrovascular Diseases

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Comparison Between Three Commonly Used Large-Bore Aspiration Catheters in Terms of Successful Recanalization and First-Passage Effect
Journal of Stroke & Cerebrovascular Diseases ( IF 2.0 ) Pub Date : 2020-12-24 , DOI: 10.1016/j.jstrokecerebrovasdis.2020.105566
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 , Prof Marina Diomedi , Fabrizio Sallustio , Francesco D'Argento , Andrea Alexandre , Andrea Romi , Alessandro Pedicelli , Prof Alfredo Berardelli , Emilio Lozupone

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.

中文翻译：

成功再通和首过效应对三种常用大口径抽吸导管的比较

目标

在最终成功的再通率和首次通过的成功与完全再通率方面比较三种常用的大口径抽吸导管（所谓的“首过效应”）。

材料和方法

这是一项观察性回顾性多中心研究，于2017年1月至2019年5月之间在意大利的三个高容量三级卒中中心进行。研究人群包括所有连续的因大脑中动脉闭塞（仅M1级）而发生缺血性卒中的患者。症状发作后24小时内以接触抽吸作为一线策略进行动脉机械血栓切除术。

结果

这项研究包括了321名患者。对三个导管进行比较的多变量logistic回归分析显示，在成功再通方面没有差异。Sofia 6 Plus导尿管与更好的首次通气成功再通相关[OR，9.09; 95％CI，2.66-31.03]（p <0.001）和首次通过完全再通[OR：3.73；95％CI：1.43-9.72]（p = 0.007），而rt-PA与较差的第一遍再通[OR：0.52; 95％CI：0.29–0.93]（p = 0.028）。