Efficacy of Mechanical Thrombectomy using Penumbra ACE(TM) Aspiration Catheter Compared to Stent Retriever Solitaire(TM) 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(TM) aspiration catheter, and the stent retriever technique, with a Solitaire(TM) 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(TM) FR stent and a Penumbra ACE(TM) 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(TM) 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 (p < 0.001) compared to the Solitaire(TM) FR group. We observed no significant difference in good clinical outcomes (52.4% vs. 56.4%, p = 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(TM) catheter is comparable to the stent retriever technique with Solitaire(TM) FR regarding clinical outcomes.