Aspiration noninferior to stent retriever for clot removal

(HealthDay)—Aspiration is as effective as the traditional stent retriever approach for clot removal in patients presenting with large-vessel occlusion stroke, according to a study published online March 9 in The Lancet.

Aquilla S. Turk III, D.O., from Greenville Health System in South Carolina, and colleagues randomly assigned 270 patients presenting at 10 hospitals and four specialty clinics in the United States and one hospital in Canada with acute ischemic stroke from anterior circulation large-vessel occlusion within six hours of onset to either direct aspiration first pass or stent retriever first-line thrombectomy.

The researchers found that at 90 days, 52 percent of patients in the aspiration group and 50 percent of patients in the stent retriever group achieved a modified Rankin score of 0 to 2. This finding demonstrated that aspiration as first pass was noninferior to stent retriever first line (Pnoninferiority = 0.0014). Rates of intracranial hemorrhage were similar between the two groups (36 percent in the aspiration first-pass group versus 34 percent in the stent retriever first-line group). At three months, all-cause mortality occurred in 22 percent of patients in each group. In addition, the aspiration-first cohort had significantly lower device costs.

“This study supports the use of direct aspiration as an alternative to stent retriever as first-line therapy for stroke thrombectomy,” conclude the authors.

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