Single-center outcome of aspiration catheter-based mechanical thrombectomy selecting the first-pass technique on a case-by-case basis

Abstract

Background and Purpose: The purpose of this study was to clarify the outcome of aspiration catheter (AC)-based mechanical thrombectomy (AC-MT) and the differences in techniques used for the first pass (FP). Methods: Consecutive patients with acute ischemic stroke who received AC-MT from April 2019 to September 2020 in our institution were enrolled. Their clinical outcomes were examined. They were categorized into the simple aspiration technique (SAT) group or the combined technique with stent retriever (CBT) group based on the FP technique. The clinical outcomes of the two groups were compared. Results: The subjects were 78 patients in which recanalization (modified thrombolysis in cerebral infarction 2b–3) was achieved in 29 (37%) patients and 73 (94%) patients at the FP and the endpoint of the procedure, respectively. Thirty-four (44%) patients had favorable outcomes (mRS 0–2 at 3 months). Thirty-five (45%) patients and 43(55%) patients were included in the SAT group and the CBT group, respectively. The number of recanalized cases was not different between the SAT group (94%) and the CBT group (93%). However, in the SAT group, compared to the CBT group, the median time from puncture to recanalization was shorter (33 minutes vs. 57 minutes) and the number of favorable outcomes was higher (57% vs. 33%). Conclusion: The recanalization rate of AC-MT was 37% at the FP. The procedure time was shorter and the number of cases of favorable outcomes was greater among patients treated with SAT as the FP than among patients treated with CBT.