Comparison of Direct Aspiration With SOFIA Distal Access Catheter and Solitaire Retrievable Stent-Induced Thrombolysis for the Treatment of Acute Ischemic Stroke

<b>Aims/Background</b> Direct aspiration with soft torqueable catheter optimized for intracranial access (SOFIA) distal access catheter and Solitaire retrievable stent-induced thrombolysis are two commonly used interventional therapy methods in acute ischemic stroke (AIS). Despite their distinctive advantages, these surgical methods need to be further studied and compared to help with treatment selection. Therefore, this study aims to analyze the distinct effects of SOFIA distal access catheter direct aspiration and Solitaire retrievable stent-induced thrombolysis in the treatment of AIS. <b>Methods</b> The clinical data of 312 patients with AIS admitted to The Quzhou Affiliated Hospital of Wenzhou Medical University from January 2019 to March 2024 were collected and analyzed retrospectively. All patients were treated with thrombectomy stents. According to different types of stents utilized, 150 patients treated with SOFIA distal access catheter direct aspiration were grouped under the SOFIA group, while 162 patients treated with Solitaire retrievable stent-induced thrombolysis were categorized in the Solitaire group. The success rate and recanalization rate following thrombolysis were compared between the two groups. The scores of National Institutes of Health Stroke Scale (NIHSS), Glasgow Coma Scale (GCS) and modified Barthel Index (MBI) before and 3 months after treatment were compared. The complications, recurrence rate and mortality of the two groups were compared 3 months after operation. <b>Results</b> There was no statistically significant difference in the success rate of mechanical thrombectomy between the two groups after treatment (<i>p</i> > 0.05), while the recanalization rate in the SOFIA group was significantly higher than that in the Solitaire group (<i>p</i> < 0.05). After treatment, the NIHSS scores of the two groups of patients were lower than before treatment, while the scores of GCS and MBI were higher than before treatment (<i>p</i> < 0.05), but there was no significant difference in these scores between the two groups (<i>p</i> > 0.05). Symptomatic intracranial hemorrhage, subarachnoid hemorrhage, arterial perforation, distal thrombosis or emboli occurred in both groups after treatment, without significant differences between the two groups (<i>p</i> > 0.05). The recurrence rate in the SOFIA group was significantly lower than that in the Solitaire group after 3 months of follow-up (<i>p</i> < 0.05), and there was no significant difference in mortality between the two groups (<i>p</i> > 0.05). <b>Conclusion</b> The SOFIA distal access catheter direct aspiration shows significant efficacy in the treatment of AIS by improving the vascular recanalization rate of AIS and reducing the recurrence rate.