129 Mechanical Thrombectomy Operative Time Reduction with Next Generation Distal Aspiration Catheters in the Treatment of Stroke due to Large Vessel Occlusion (LVO)

INTRODUCTION: The newest generation distal thrombectomy catheters are intended for use with larger wires in lieu of a microcatheter in triaxial aspiration thrombectomy systems used for the treatment of LVO strokes. METHODS: The stroke thrombectomy time cards and outcomes for all patients from October 2022 to March 2023 and April 2023 to September 2023 at our institution were retrospectively reviewed. The time intervals in question correspond to the thrombectomies performed prior to and after implementation of the Penumbra Red 43 distal aspiration catheter in lieu of a microcatheter at our institution, respectively. Patients with posterior circulation strokes and those performed by providers not performing thrombectomies at our institution during the entire indexed period were excluded. RESULTS: During the indexed 12 months, one hundred and nine thrombectomies were performed. Eighty-one patients were included in this retrospective review. After the implementation of the smaller next generation of small distal aspiration catheters, there was a 6% reduction (p=0.2) in groin puncture to first device time and a 21% reduction (p<0.05) in groin puncture to final revascularization time. In addition, there was a 25% reduction in utilization of stent retrievers. There was no statistically significant difference in the clinical outcomes of the two groups. CONCLUSIONS: The utilization of the latest generation of distal aspiration catheters in lieu of microcatheters is a viable means of reduction of operative time in the treatment of LVO stroke, which appears to be predominantly related to reduction in stent retriever utilization and may result in cost savings. However, larger studies are needed to evaluate the resultant clinical outcomes.