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  • Frontline Therapy with the ACE Reperfusion Catheters in an Acute Ischemic Stroke Cohort

    Final Number:
    172

    Authors:
    Josser Delgado Almandoz MD

    Study Design:
    Clinical trial

    Subject Category:
    Ischemic Stroke

    Meeting: AANS/CNS Cerebrovascular Section 2018 Annual Meeting

    Introduction: The aim of this study is to determine effectiveness of ACE reperfusion catheters as frontline therapy in ELVO patients

    Methods: We conducted a single-center retrospective study of 100 consecutive patients treated for anterior ELVOs using aspiration thrombectomy (ACE60, ACE64, ACE68) frontline. Study outcomes included mTICI 2b/3; procedural time; and mRS 0-2 at 90 days.

    Results: Aspiration thrombectomy alone was performed in 84 of the 100 patients, achieving mTICI 2b/3 in 78 (93%). Successful reperfusion with aspiration only was achieved in 64% of patients treated with ACE60, 88% with ACE64, and 100% with ACE68 (p<0.001). Single-pass mTICI 2b/3 was achieved in 31% treated with ACE60, 38% with ACE64, and 50% with ACE68. Mean puncture to reperfusion time with ACE60 was 48.8 minutes and 30 minutes with ACE64/68 (p=0.002). At 90 days, 49% (41/84) treated with aspiration only achieved mRS 0-2. Adjunctive stent retriever was used in 16 patients following unsuccessful aspiration, achieving mTICI 2b/3 in 12 (75%). At 90 days, mRS 0-2 was observed in 31% (5/16) of these patients. Puncture-to-reperfusion time was shorter for those successfully revascularized with ACE alone (30.5 minutes) than patients needing adjunctive therapy (81.8 minutes, p<0.0001). 90% (90/100) of patients achieved mTICI 2b/3, with a mean time of 38.7 minutes from puncture. Adjunctive stent retriever use was higher in the first 20 patients (45%) than the subsequent 80 (9%) (p=0.0004). mTICI 2b/3 using aspiration alone was achieved in 50% of the first 20 cases and in 85% of the subsequent 80 (p=0.002).

    Conclusions: Large bore ACE reperfusion catheters are fast and effective frontline thrombectomy therapy while still maintaining flexibility for combination therapy.

    Patient Care: By bring this new data on large bore ACE reperfusion catheters for aspiration mechanical thrombectomy therapy in patients with acute ischemic strokes from emergent large vessel occlusions (ELVO), while still maintaining flexibility to use adjuvant traetment when needed.

    Learning Objectives: The data from this trial has demonstrated that the ACE reperfusion catheters ACE 64 and ACE 68 are effective as frontline mechanical thrombectomy therapy in patients with acute ischemic strokes from emergent large vessel occlusions (ELVO).

    References:

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