{
  "abstract": "Background Acute intracranial internal carotid artery (ICA) occlusion lowers first-pass reperfusion rates and clinical outcomes. Aspiration catheter and stent-retriever thrombectomy (CA+SR) is becoming a first-line approach, but data on its performance versus contact aspiration alone (CA) in real-world practice using newer large-bore catheters are scarce. We compared angiographic and clinical outcomes between CA and CA+SR strategies for ICA occlusion.Methods Patients with isolated intracranial ICA occlusion treated between January and December 2024 were included in this multicenter SARA-3 registry study. Patients were grouped by first-line technique (CA or CA+SR). We compared procedural times, angiographic outcomes (modified Thrombolysis in Cerebral Infarction (mTICI) score), and clinical outcomes (24-hour National Institutes of Health Stroke Scale (NIHSS) and 3 month modified Rankin Scale (mRS) scores).Results Of 181 patients (median age, 74 years; 51% women), 53 received CA and 128 CA+SR. In CA, 75% achieved final recanalization (mTICI 2c–3) compared with 86% (CA+SR) (P=0.066), with similar procedural times and complications. No differences were found between 48% and 39% of patients who achieved first-pass mTICI 2b-3. The overall cohort had a 64% favorable outcome (mRS ≤2 at 3 months), with CA showing higher rates (70% vs 62%; P=0.4). Complete first-pass recanalization reduced symptomatic intracranial hemorrhages (ICH) and embolization but did not improve functional outcomes.Conclusion With newer large-bore aspiration catheters, CA was comparable to CA+SR as a first-line technique for intracranial ICA occlusion, with similar recanalization rates and favorable clinical outcomes.",
  "authors": [
    {
      "affiliations": [
        "Department of Diagnostic and Interventional Neuroradiology, La Paz University Hospital, Hospital La Paz Institute for Health Research-IdiPAZ, Madrid, Spain, La Paz University Hospital, Madrid, Spain"
      ],
      "name": "Miguel Ramírez-Torres"
    },
    {
      "affiliations": [
        "Department of Diagnostic and Interventional Neuroradiology, La Paz University Hospital, Hospital La Paz Institute for Health Research-IdiPAZ, Madrid, Spain, La Paz University Hospital, Madrid, Spain"
      ],
      "name": "Andrés Javier Barrios"
    },
    {
      "affiliations": [
        "Department of Radiology, Hospital Universitario Son Espases, Palma, Illes Balears, Spain"
      ],
      "name": "Angel Calleja Bonilla"
    },
    {
      "affiliations": [
        "Department of Radiology, Hospital Universitario Son Espases, Palma, Illes Balears, Spain"
      ],
      "name": "Joaquin Ortega-Quintanilla"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Hospital General Universitario de Alicante, Alicante, Spain"
      ],
      "name": "Carlos Dominguez Rodriguez"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Hospital General Universitario de Alicante, Alicante, Spain"
      ],
      "name": "Antonio Sagredo-Barra"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Región de Murcia, Spain"
      ],
      "name": "Jose Díaz-Pérez"
    },
    {
      "affiliations": [
        "Department of Radiology, Hospital Universitario Puerta del Mar, Cadiz, Andalucía, Spain"
      ],
      "name": "Amado Rodriguez-Benitez"
    },
    {
      "affiliations": [
        "Department of Radiology, Hospital Puerta del Mar, Cádiz, Spain"
      ],
      "name": "Juan Garcia-Villanego"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Complexo Hospitalario Universitario A Coruna, A Coruña, Spain"
      ],
      "name": "Alberto Martinez-Calvo"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Complexo Hospitalario Universitario A Coruna, A Coruña, Spain"
      ],
      "name": "Jose-Luis Díaz-Valiño"
    },
    {
      "affiliations": [
        "Department of Radiology, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain"
      ],
      "name": "Cristian Ormeño Anturiano"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Puerta de Hierro University Hospital of Majadahonda, Majadahonda, Comunidad de Madrid, Spain"
      ],
      "name": "Carmen de la Rosa"
    },
    {
      "affiliations": [
        "Department of Radiology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain"
      ],
      "name": "Antonio Jesús Mosqueira"
    },
    {
      "affiliations": [
        "Department of Radiology, Hospital de Navarra, Pamplona, Navarre, Spain"
      ],
      "name": "Rebeca Bermejo Garcés"
    },
    {
      "affiliations": [
        "Department of Radiology, Hospital Universitario de Cáceres, Cáceres, Spain"
      ],
      "name": "Juan Chaviano"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Hospital Ramón y Cajal, Madrid, Madrid, Spain"
      ],
      "name": "Isabel Bermúdez-Coronel"
    },
    {
      "affiliations": [
        "Neurointerventional Unit, Hospital Clinico Universitario San Carlos, Madrid, Spain"
      ],
      "name": "Carlos Pérez-García"
    },
    {
      "affiliations": [
        "Department of Radiology, Complexo Hospitalario Universitario de Vigo, Vigo, Galicia, Spain"
      ],
      "name": "Carlos Manuel Rodriguez-Paz"
    },
    {
      "affiliations": [
        "Department of Radiology, Complejo Hospitalario Torrecardenas, Almeria, Andalucía, Spain"
      ],
      "name": "Carlos Hidalgo-Barranco"
    },
    {
      "affiliations": [
        "Interventional Radiology, Hospital Universitario de Álava, Vitoria-Gasteiz, País Vasco, Spain"
      ],
      "name": "Franscisco Javier Maynar"
    },
    {
      "affiliations": [
        "Interventional Radiology, Hospital Universitario La Princesa, Madrid, Spain"
      ],
      "name": "Juan Vega-Villar"
    },
    {
      "affiliations": [
        "Interventional Radiology, Complejo Hospitalario Universitario Albacete, Castilla-La Mancha, Spain"
      ],
      "name": "Juan David Molina-Nuevo"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Hospital Universitario Central de Asturias, Asturias, Spain"
      ],
      "name": "Víctor Maestro"
    },
    {
      "affiliations": [
        "Interventional Radiology, Hospital Universitario La Fe, Valencia, Spain"
      ],
      "name": "Juan Manuel Sanchís-García"
    },
    {
      "affiliations": [
        "Interventional Radiology, Hospital Universitario de León, León, Spain"
      ],
      "name": "Oscar Balboa Arregui"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain"
      ],
      "name": "Mario Martínez-Galdámez"
    },
    {
      "affiliations": [
        "Department of Radiology, Hospital Universitario de Donostia, Guipúzcoa, Spain"
      ],
      "name": "Eñaut Garmendia Lopetegui"
    },
    {
      "affiliations": [
        "Department of Computer Science, Applied Mathematics and Statistics, University of Girona, Girona, Spain"
      ],
      "name": "Marc Comas-Cufí"
    },
    {
      "affiliations": [
        "Radiology Department CDI, Hospital Clinic of Barcelona and IDIBAPS, Barcelona, Spain"
      ],
      "name": "Josep Puig"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Región de Murcia, Spain"
      ],
      "name": "Joaquín Zamarro"
    },
    {
      "affiliations": [
        "Department of Diagnostic and Interventional Neuroradiology, La Paz University Hospital, Hospital La Paz Institute for Health Research-IdiPAZ, Madrid, Spain, La Paz University Hospital, Madrid, Spain"
      ],
      "name": "Pedro Navia"
    }
  ],
  "title": "Comparison between contact aspiration alone and combined thrombectomy for intracranial internal carotid artery occlusion: insights from SARA-3 registry",
  "uid": "a6cbc91d-68a3-5504-a678-ebab2c850bfb"
}