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Frontline contact aspiration thrombectomy using SOFIA catheter for acute ischemic stroke: period-to-period comparison with Penumbra catheter

  • Original Article - Vascular Neurosurgery - Ischemia
  • Published:
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Abstract

Background

Recent aspiration thrombectomy devices tend to have a more flexible distal tip and larger bore for easy target access and effective reperfusion. Here, this study primarily focused on the efficacy and safety of the SOFIA catheters when it was used as a frontline contact aspiration thrombectomy (CAT) tool for acute intracranial large vessel occlusion in comparison with the data from a period when the Penumbra catheter was used.

Methods

The subjects comprised 189 patients who underwent CAT (90 with Penumbra Max family and 99 with SOFIA/SOFIA plus). Patients’ data were retrospectively analyzed to evaluate overall clinical and angiographic outcomes and compared between the devices.

Results

Baseline characteristics were similar between groups. But, intravenous alteplase was more frequently administered in the Penumbra group (43.3% vs. 29.3%, p = 0.045), while incidence of ICA occlusion was higher in SOFIA group (18.9% vs. 38.4%, p = 0.013). The modified thrombolysis in cerebral infarction 2b-3 of reperfusion was 94.4% for the Penumbra group and 92.9% for the SOFIA group (p = 0.656). The first-pass effect was more frequently achieved in the SOFIA group (20.0% vs. 39.4%, p = 0.004) and endovascular procedure time was significantly shorter (55.5 min vs. 36 min, p < 0.001). However, clinical outcomes did not differ significantly regarding mortality (11.1% vs. 6.1%, p = 0.213), hemorrhagic complications, and mRS 0–2 at 3 months (63.3% vs. 58.6%; p = 0.504).

Conclusion

CAT using SOFIA may be safe and comparable to thrombectomy using the Penumbra reperfusion catheter. And, the SOFIA catheter could be advantageous for rapid reperfusion and first-pass effect without any significant complications.

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Abbreviations

AIS:

Acute ischemic stroke

CAT:

Contact aspiration thrombectomy

EVT:

Endovascular thrombectomy

FPE:

First-pass effect

LVO:

Large vessel occlusion

SRT:

Stent retriever thrombectomy

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Authors and Affiliations

  1. Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea

    Yong-Won Kim & Yang-Ha Hwang

  2. Department of Radiology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea

    Yong-Won Kim, Yong-Sun Kim & Dong-Hun Kang

  3. Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea

    Dong-Hun Kang

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  1. Yong-Won Kim
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Correspondence to Dong-Hun Kang.

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Kim, YW., Hwang, YH., Kim, YS. et al. Frontline contact aspiration thrombectomy using SOFIA catheter for acute ischemic stroke: period-to-period comparison with Penumbra catheter. Acta Neurochir 161, 1197–1204 (2019). https://doi.org/10.1007/s00701-019-03914-4

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