Effect of Endovascular Contact Aspiration vs Stent Retriever on Revascularization in Patients With Acute Ischemic Stroke and Large Vessel Occlusion

Abstract

After recent reports from 6 randomized clinical trials (RCTs) demonstrated the superiority of mechanical thrombectomy over standard medical management alone, research priorities shifted toward reducing time to revascularization, optimizing imaging methods for patient selection, and evaluating new thrombectomy devices.^1-3 Because stent retriever techniques were used predominantly in these trials, questions remain regarding the safety and efficacy of aspiration thrombectomy techniques as a first-line therapy. A direct aspiration first-pass technique (ADAPT), or contact aspiration, involves the first-line use of aspiration through a large-bore catheter,^4-8 then adding a stent retriever if needed. In cases in which aspiration alone is not successful in removing the thrombus, the large-bore aspiration catheter provides the additional benefit of offering access for a stent retriever.