Factors Associated With Improved Technical Outcomes When Using 0.068‐ to 0.074‐Inch Aspiration Catheters: Analysis From a Multicenter Retrospective Cohort

Background In addition to enlarging the catheter tip diameter, recent aspiration catheters were designed with a novel angled‐tip design. We aimed to evaluate the efficacy of new‐generation angled‐tip aspiration catheters in comparison to commonly used straight‐tip large‐bore aspiration catheters. Methods We performed a multicenter retrospective analysis of consecutive cases with M1 occlusion treated with aspiration thrombectomy from July 2016 to February 2021. Patients were divided into 2 cohorts: those in whom a 0.071‐inch angled‐tip catheter was used and those in whom a 0.068‐ to 0.074‐inch flat‐tip catheter was used. Results A total of 384 patients were identified. The angled‐tip catheter was used in 129 (33.6%) patients, whereas 255 (66.4%) patients were treated with flat‐tip catheters. There was no significant difference in age, sex, baseline modified Rankin scale score, side of occlusion, initial National Institutes of Health Stroke Scale score, time from last known normal to access, or rate of intravenous recombinant tPA (tissue‐type plasminogen activator) administration. Use of the angled‐tip reperfusion catheter was associated with average 5‐minute faster time to Thrombolysis in Cerebral Infarction 2B or better (22.13±21.05 versus 27±24.54 minutes; P =0.012) and 7‐minute faster time to final recanalization (25.85±25.22 versus 32.96±29.26 minutes; P =0.011). There was no difference in the rate of good outcome or hemorrhagic transformation. Conclusions We report a multicenter, retrospective review of patients treated with current generation large‐bore aspiration catheters. Angled‐tipped catheters were associated with shorter times to Thrombolysis in Cerebral Infarction 2B and final reperfusion. There were no differences in 90‐day modified Rankin scale score, rates of intracranial hemorrhage, or complications.