BACKGROUND: Mechanical thrombectomy is the standard therapy in patients with acute ischemic stroke (AIS). The primary aim of our study was to compare the procedural efficacy of the direct aspiration technique, using Penumbra ACETM aspiration catheter, and the stent retriever technique, with a SolitaireTM FR stent. Secondarily, we investigated treatment-dependent and treatment-independent factors that predict a good clinical outcome. METHODS: We analyzed our series of mechanical thrombectomies using a SolitaireTM FR stent and a Penumbra ACETM catheter. The clinical and radiographic data of 76 patients were retrospectively reviewed. Using binary logistic regression, we looked for the predictors of a good clinical outcome. RESULTS: In the Penumbra ACETM group we achieved significantly higher rates of complete vessel recanalization with lower device passage counts, shorter recanalization times, shorter procedure times and shorter fluoroscopy times (p < 0.001) compared to the SolitaireTM FR group. We observed no significant difference in good clinical outcomes (52.4% vs. 56.4%, p = 0.756). Predictors of a good clinical outcome were lower initial NIHSS scores, pial arterial collateralization on admission head CT angiography scan, shorter recanalization times and device passage counts. CONCLUSIONS: The aspiration technique using Penumbra ACETM catheter is comparable to the stent retriever technique with SolitaireTM FR regarding clinical outcomes.

Department of Neurosurgery and Interventional Neuroradiology Donau Isar Klinikum Perlasberger Str 41 94469 Deggendorf Germany

Department of Radiology and Interventional Radiology Donau Isar Klinikum Perlasberger Str 41 94469 Deggendorf Germany

Department of Statistics Faculty of Economic Informatics University of Economics in Bratislava Dolnozemska cesta 1 b 85235 Bratislava Slovakia

Neurosurgical Clinic Campus Grosshadern Clinic of the University of Munich Marchioninistrasse 15 81377 Munich Germany

Radiodiagnostic Departement Military University Hospital Prague U Vojenské nemocnice 1200 16902 Praha Czech Republic

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