Thrombectomy is the standard of care in acute ischemic stroke with large vessel occlusion in selected patients presenting up to 24 hours after the onset of symptoms. Every incremental delay in achieving vessel recanalisation in patients with large vessel ischemic stokes results in a reduced likelihood of achieving independent functional outcome following thrombectomy. The majority of thrombectomy trials have primarily used second generation stent-retriever devices. However, aspiration techniques have also been described and demonstrated to be successful, but appear to be less widespread in their...

A consecutive cohort of thrombectomy procedures from our prospectively maintained stroke database was analysed. These were consecutive patients from 3 separate operators who have adopted the aspiration-first technique. Patients are included even if the aspiration was not possible; i.e. on an intention to treat basis. The concept is to see the effect of this standardised approach on all patients. As a control we included consecutive patients who underwent primary stent-retrieval by the same operators over a similar time period, prior to commencing this technique. We...

A total of 127 consecutive patients with intracranial anterior circulation vessel occlusion underwent thrombectomy by an intention to treat using the aspiration first technique from September 2017 to September 2018. This group was compared to 127 consecutive thrombectomies performed between April 2016 and May 2017 who were primarily treated with stent-retriever method. On analysis of aspiration used as the first technique, there were a total of 91 aspiration cases and 163 stent-retriever first techniques. The baseline demographics, NIHSS, those undergoing thrombolysis and Thrombolysis in Cerebral...

In a procedure where time-is-brain any opportunity to improve times and success should be taken. Our study highlights the increasing speed and recanalisation rates achieved with fewer passes in a standardised approach to thrombectomy with an intention to attempt aspiration first, with an overall reduced procedure length. This differs from recently published and soon to be presented meta-analyses, which have shown aspiration to have better success at recanalisation compared to stent-retrievers but no benefit in terms of the number of passes or time to reperfusion....

Contact Details: Dr David Brennan Department of Radiology, Beaumont Hospital, Beaumont, D9, Ireland [email protected]

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