Efficacy of Mechanical Thrombectomy using Penumbra ACE Aspiration Catheter Compared to Stent Retriever Solitaire FR in Patients with Acute Ischemic Stroke.

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 ACE aspiration catheter, and the stent retriever technique, with a Solitaire 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 Solitaire FR stent and a Penumbra ACE 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 ACE 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 ( < 0.001) compared to the Solitaire FR group. We observed no significant difference in good clinical outcomes (52.4% vs. 56.4%, = 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 ACE catheter is comparable to the stent retriever technique with Solitaire FR regarding clinical outcomes.