First-line Aspiration Thrombectomy with the RED43 Catheter for Acute Ischemic Stroke due to Medium or Distal Vessel Occlusion
(2025) In Clinical Neuroradiology- Abstract
PURPOSE: Techniques for endovascular thrombectomy in acute ischemic stroke due to medium or distal vessel occlusions (MDVO) need to be improved, and first-line aspiration is emerging as a promising technique. The objective was to describe first-pass and final reperfusion rates with a triaxial direct aspiration first pass technique (ADAPT) and a novel, quadriaxial technique (QUATTRO-ADAPT) using RED43 Reperfusion Catheters to target MDVOs.
METHODS: This retrospective study collected data from 11 stroke centers in Europe and North America between 2023 and 2025. Patients with primary, isolated MDVOs who underwent thrombectomy using first-line aspiration with RED43 Reperfusion Catheters were included. Primary outcome was first-pass... (More)
PURPOSE: Techniques for endovascular thrombectomy in acute ischemic stroke due to medium or distal vessel occlusions (MDVO) need to be improved, and first-line aspiration is emerging as a promising technique. The objective was to describe first-pass and final reperfusion rates with a triaxial direct aspiration first pass technique (ADAPT) and a novel, quadriaxial technique (QUATTRO-ADAPT) using RED43 Reperfusion Catheters to target MDVOs.
METHODS: This retrospective study collected data from 11 stroke centers in Europe and North America between 2023 and 2025. Patients with primary, isolated MDVOs who underwent thrombectomy using first-line aspiration with RED43 Reperfusion Catheters were included. Primary outcome was first-pass successful reperfusion rate (modified Treatment In Cerebral Infarction score ≥ 2b). Additionally, final reperfusion rates, complications and functional outcomes up to 90 days were evaluated.
RESULTS: We included 85 cases. Median age was 74 years (IQR 67-81) and median National Institutes of Health Stroke Scale score 9 (IQR 6-15). The majority (69.4%) had an occlusion of the co- or nondominant M2 segment of the middle cerebral artery. First-pass successful reperfusion was 63.5% overall, with 55.6% for the triaxial ADAPT and 69.4% for the quadriaxial QUATTRO-ADAPT. Final successful reperfusion was achieved in 96.5%. Complications included vessel perforations (2.4%), subarachnoid hemorrhage (3.5%), parenchymal hematoma type 2 (2.4%), and symptomatic intracerebral hemorrhage (1.2%). Functional independence (modified Rankin Scale 0-2) at 90 days was observed in 58.7%.
CONCLUSION: This study shows that first-line aspiration, especially in a quadriaxial approach, can be effective and safe. These findings should be evaluated in prospective trials.
(Less)
- author
- Aebischer, Vera
; Brehm, Alex
; Rommers, Nikki
; Spiotta, Alejandro
; Sowlat, Mohammad
; Raghuram, Karthik
; Cappuzzo, Justin M
; Beecher, Jeffrey
; Matouk, Charles
; Amllay, Abdelaziz
; Rohr, Axel
; Heran, Manraj
; Volders, David
; Mosimann, Pascal J
; Al-Tibi, Mohammad
; Wassélius, Johan
LU
; Hansen, Björn M
LU
; Holtmannspötter, Markus
; Schlösser, Martin
; Meckel, Stephan
; Aoua, Oumaima
; Giragani, Suresh
; Boghi, Andrea
; Ntoulias, Nikolaos
; Schulze-Zachau, Victor
; Tsogkas, Ioannis
; Blackham, Kristine A
; Anastasiou, Aikaterini
and Psychogios, Marios
(Less) - organization
- publishing date
- 2025-09-29
- type
- Contribution to journal
- publication status
- epub
- subject
- in
- Clinical Neuroradiology
- publisher
- Springer Science and Business Media B.V.
- external identifiers
-
- pmid:41023241
- ISSN
- 1869-1439
- DOI
- 10.1007/s00062-025-01567-8
- language
- English
- LU publication?
- yes
- additional info
- © 2025. The Author(s).
- id
- 6c87374c-5673-48eb-9ca7-45655ee626b8
- date added to LUP
- 2025-10-02 14:28:54
- date last changed
- 2025-10-03 02:50:30
@article{6c87374c-5673-48eb-9ca7-45655ee626b8,
abstract = {{<p>PURPOSE: Techniques for endovascular thrombectomy in acute ischemic stroke due to medium or distal vessel occlusions (MDVO) need to be improved, and first-line aspiration is emerging as a promising technique. The objective was to describe first-pass and final reperfusion rates with a triaxial direct aspiration first pass technique (ADAPT) and a novel, quadriaxial technique (QUATTRO-ADAPT) using RED43 Reperfusion Catheters to target MDVOs.</p><p>METHODS: This retrospective study collected data from 11 stroke centers in Europe and North America between 2023 and 2025. Patients with primary, isolated MDVOs who underwent thrombectomy using first-line aspiration with RED43 Reperfusion Catheters were included. Primary outcome was first-pass successful reperfusion rate (modified Treatment In Cerebral Infarction score ≥ 2b). Additionally, final reperfusion rates, complications and functional outcomes up to 90 days were evaluated.</p><p>RESULTS: We included 85 cases. Median age was 74 years (IQR 67-81) and median National Institutes of Health Stroke Scale score 9 (IQR 6-15). The majority (69.4%) had an occlusion of the co- or nondominant M2 segment of the middle cerebral artery. First-pass successful reperfusion was 63.5% overall, with 55.6% for the triaxial ADAPT and 69.4% for the quadriaxial QUATTRO-ADAPT. Final successful reperfusion was achieved in 96.5%. Complications included vessel perforations (2.4%), subarachnoid hemorrhage (3.5%), parenchymal hematoma type 2 (2.4%), and symptomatic intracerebral hemorrhage (1.2%). Functional independence (modified Rankin Scale 0-2) at 90 days was observed in 58.7%.</p><p>CONCLUSION: This study shows that first-line aspiration, especially in a quadriaxial approach, can be effective and safe. These findings should be evaluated in prospective trials.</p>}},
author = {{Aebischer, Vera and Brehm, Alex and Rommers, Nikki and Spiotta, Alejandro and Sowlat, Mohammad and Raghuram, Karthik and Cappuzzo, Justin M and Beecher, Jeffrey and Matouk, Charles and Amllay, Abdelaziz and Rohr, Axel and Heran, Manraj and Volders, David and Mosimann, Pascal J and Al-Tibi, Mohammad and Wassélius, Johan and Hansen, Björn M and Holtmannspötter, Markus and Schlösser, Martin and Meckel, Stephan and Aoua, Oumaima and Giragani, Suresh and Boghi, Andrea and Ntoulias, Nikolaos and Schulze-Zachau, Victor and Tsogkas, Ioannis and Blackham, Kristine A and Anastasiou, Aikaterini and Psychogios, Marios}},
issn = {{1869-1439}},
language = {{eng}},
month = {{09}},
publisher = {{Springer Science and Business Media B.V.}},
series = {{Clinical Neuroradiology}},
title = {{First-line Aspiration Thrombectomy with the RED43 Catheter for Acute Ischemic Stroke due to Medium or Distal Vessel Occlusion}},
url = {{http://dx.doi.org/10.1007/s00062-025-01567-8}},
doi = {{10.1007/s00062-025-01567-8}},
year = {{2025}},
}