E-020 Efficacy and safety of large bore catheters versus stent retrievers in mechanical thrombectomy for large vessel occlusion: initial single center experience

Introduction The use of large bore catheters (LBC) for mechanical thrombectomy (MT) has increased in the last years. However, the use of larger catheters might raise concerns for possible adverse events when compared to stent retriever (SR) devices. We aimed to analyze the efficacy outcomes and safety profile of LBC versus SR for MT.Methods We conducted a retrospective analysis of our local repository of MT from 2023-2026. Inclusion criteria involved patients with acute ischemic stroke due to a large vessel occlusion and underwent MT using LBC. The use of LBC included aspiration catheters with inner diameters ≥ 0.088. Demographic and clinical information were retrieved from electronical medical records. Efficacy outcomes included first pass effect (FPE) defined as a modified thrombolysis in cerebral infarction (mTICI 2c-3) on the first MT attempt. Likewise, complete (mTICI 3) and excellent (mTICI >2c) final reperfusion was also addressed. Safety outcomes involved hemorrhagic transformation, distal embolization, in-hospital mortality and mortality at 90 days. Patients with LBC included were then matched by Alberta Stroke Program Early CT Score (ASPECTS) with patients that underwent MT using SR as first-line approach. Multivariate logistic regression was conducted.Results A total of 53 patients were included: 27/53 (50.9%) were treated with Cereglide 92, 16/53 (30.2%) with Broadway 8, 7/53 (13.2%) with Sofia 88, 2/53 (3.8%) with Toro 88, and 1/53 (1.9%) with Route 92. The use of LBC was associated with a higher odd of FPE (OR 3.06, 95% CI 1.36 - 6.85, p = 0.006) but not to a final complete (OR 1.84, 95% CI 0.85 - 3.98, p = 0.121) or excellent reperfusion (OR 1.69, 95% CI 0.68 - 4.22, p = 0.255). Likewise, distal embolization (OR 0.28, 95% CI 0.11 - 0.71, p = 0.006) and mortality at 90 days (OR 0.37, 95% CI 0.14 - 0.97, p = 0.04) was less likely to occur when using LBC compared to SR. No association was found between hemorrhagic transformation (OR 0.63, 95% CI 0.29 - 1.36, p = 0.242) or in-hospital mortality (OR 0.72, 95% CI 0.29 - 1.79, p = 0.493) when using LBC.Conclusion The use of LBC is safe and effective for MT when compared to SR.Disclosures A. Gudino: None. M. Godoy: None. L. Gudino: None. J. Manrique: None. A. Ashok: None. A. Rivadeneira-Limongi: None. M. Hinojosa Figueroa: None. S. Biswas: None. E. Samaniego: None.