{
  "abstract": "Background Combined delivery catheter systems (CDCS) with ledge-reducing obturators are designed to streamline aspiration-first mechanical thrombectomy, yet comparative multicenter data across platforms remain limited.Objective To determine whether an aspiration-first CDCS strategy improves procedural efficiency without compromising angiographic success or safety compared with traditional aspiration systems.Methods A multicenter, retrospective cohort study was conducted using prospectively maintained registries of consecutive aspiration-first thrombectomies at three comprehensive stroke centers in the United States (June 2023–January 2025). CDCS (Route 92 FreeClimb 70-Tenzing, Penumbra RED 72-SENDit, Balt Carrier, Q’Apel Hippo-Cheetah) were compared with conventional microcatheter-guided aspiration. Primary outcome was groin-to-final-reperfusion time. Secondary outcomes included first-pass and final extended Thrombolysis in Cerebral Infarction (eTICI)≥2b reperfusion, number of passes, fluoroscopy time, symptomatic intracranial hemorrhage, and 90-day modified Rankin Scale scores. Multivariable models were adjusted for prespecified covariates.Results The primary outcome, groin-to-final-reperfusion time (26.0 vs 41.0 min, p=0.001), was significantly shorter with CDCS (n=66). Secondary outcomes demonstrated fewer number of passes (1.8±1.3 vs 2.3±1.4, p=0.02), higher first-pass eTICI≥2b (66.7% vs 44.9%, p=0.009) and final eTICI≥2b (92.4% vs 78.2%, p=0.02) reperfusion rates, and lower fluoroscopy times (18.8 vs 24.5 min, p=0.02). Symptomatic intracranial hemorrhage occurred in 4.6% of CDCS versus 12.8% of traditional cases (p=0.14). There was no significant difference in 90-day functional outcomes between groups (3.6±1.9 vs 3.5±2.6, p=0.82). Findings remained significant after adjustment where applicable.Conclusions An aspiration-first CDCS strategy was associated with faster reperfusion and higher angiographic success without apparent safety trade-offs. Prospective comparative and cost-effectiveness studies are warranted.",
  "authors": [
    {
      "affiliations": [
        "Radiological Sciences, Division of Interventional Neuroradiology, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, California, USA",
        "Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA"
      ],
      "name": "Keiko A Fukuda"
    },
    {
      "affiliations": [
        "Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA"
      ],
      "name": "Mallory Blackwood"
    },
    {
      "affiliations": [
        "Radiological Sciences, Division of Interventional Neuroradiology, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, California, USA"
      ],
      "name": "Jungyoon Kim"
    },
    {
      "affiliations": [
        "Radiological Sciences, Division of Interventional Neuroradiology, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, California, USA"
      ],
      "name": "Catherine Peterson"
    },
    {
      "affiliations": [
        "Radiological Sciences, Division of Interventional Neuroradiology, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, California, USA",
        "Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA"
      ],
      "name": "Charles Beaman"
    },
    {
      "affiliations": [
        "Radiological Sciences, Division of Interventional Neuroradiology, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, California, USA"
      ],
      "name": "Nefize Turan"
    },
    {
      "affiliations": [
        "Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA"
      ],
      "name": "Amir Molaie"
    },
    {
      "affiliations": [
        "Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA"
      ],
      "name": "David S Liebeskind"
    },
    {
      "affiliations": [
        "Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA"
      ],
      "name": "Latisha Sharma"
    },
    {
      "affiliations": [
        "Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA",
        "Comprehensive Stroke Center and Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA"
      ],
      "name": "Jeffrey L Saver"
    },
    {
      "affiliations": [
        "Radiological Sciences, Division of Interventional Neuroradiology, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, California, USA"
      ],
      "name": "Naoki Kaneko"
    },
    {
      "affiliations": [
        "Radiological Sciences, Division of Interventional Neuroradiology, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, California, USA",
        "Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA"
      ],
      "name": "May Nour"
    },
    {
      "affiliations": [
        "Radiological Sciences, Division of Interventional Neuroradiology, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, California, USA",
        "Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA"
      ],
      "name": "Geoffrey P Colby"
    },
    {
      "affiliations": [
        "Radiological Sciences, Division of Interventional Neuroradiology, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, California, USA"
      ],
      "name": "Satoshi Tateshima"
    },
    {
      "affiliations": [
        "Radiological Sciences, Division of Interventional Neuroradiology, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, California, USA"
      ],
      "name": "Reza Jahan"
    },
    {
      "affiliations": [
        "Radiological Sciences, Division of Interventional Neuroradiology, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, California, USA"
      ],
      "name": "Gary Duckwiler"
    },
    {
      "affiliations": [
        "Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA"
      ],
      "name": "Aaron Rodriguez-Calienes"
    },
    {
      "affiliations": [
        "Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, USA"
      ],
      "name": "Luis Guada"
    },
    {
      "affiliations": [
        "Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, USA"
      ],
      "name": "Turki Elarjani"
    },
    {
      "affiliations": [
        "Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA"
      ],
      "name": "Dileep Yavagal"
    },
    {
      "affiliations": [
        "Neurology, University of Texas Houston McGovern School of Medicine, Houston, Texas, USA"
      ],
      "name": "Joseph N Samaha"
    },
    {
      "affiliations": [
        "Neurology, University of Texas Houston McGovern School of Medicine, Houston, Texas, USA"
      ],
      "name": "Sunil A Sheth"
    },
    {
      "affiliations": [
        "Radiological Sciences, Division of Interventional Neuroradiology, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, California, USA"
      ],
      "name": "Viktor Szeder"
    }
  ],
  "title": "Faster reperfusion with combined delivery catheter systems in aspiration-first stroke thrombectomy: a multicenter analysis",
  "uid": "500114bb-966d-5573-acb8-8e26baceb557"
}