Abstract 057: Outcomes in Patients with Aspiration vs Stent Retriever Thrombectomy

Introduction There are currently multiple devices cleared by the FDA for endovascular therapy in acute ischemic stroke. While data on the superior efficacy of dual stent retriever and aspiration catheter techniques for mechanical thrombectomy (MT) is mixed, our study compares outcomes between the stent retriever and aspiration techniques. Method We reviewed 257 patients with large vessel occlusion (LVO) who underwent mechanical thrombectomy (MT) between 2018 and June 2023. From this cohort, we identified 48 patients: 22 who underwent MT exclusively with a stent retriever and 26 who underwent MT using an aspiration catheter. Patients who received dual‐device MT were excluded from the study. Our primary outcomes included successful recanalization, defined as a modified Thrombolysis in Cerebral Ischemia (TICI) score of greater than or equal to 2b, the duration of intensive care unit (ICU) stay, and a 90‐day modified Rankin Scale (mRS) score of 0‐3. Secondary outcomes included the number of passes and complications, such as intracranial hemorrhage (ICH). Results Baseline characteristics, including age and BMI, were comparable between the two groups. The proportion of patients achieving a good outcome (TICI score greater than or equal to 2b) was 90.9% in the stent retriever group compared to 84.6% in the aspiration catheter group. The average ICU stay was 5.6 days for the stent retriever group and 3 days for the aspiration catheter group. The proportion of patients with a favorable 90‐day mRS score (0‐3) was 69.2% in the stent retriever group and 85.7% in the aspiration catheter group. First‐pass effect occurred in 72.7% of patients in the stent retriever group, compared to 57.7% in the aspiration catheter group. Intracranial hemorrhage (ICH) was observed in 28.6% of patients in the stent retriever group and 19.2% in the aspiration catheter group (p=0.45). Conclusion Our study found that the stent retriever technique resulted in better recanalization and fewer passes compared to the aspiration catheter. However, the aspiration catheter group had shorter ICU stays, better functional outcomes, and fewer complications. With newer devices, further research with standardized techniques is needed to provide more clarity on these findings.