{
  "abstract": "Background Endovascular thrombectomy (EVT) is a cornerstone treatment for acute ischemic stroke (AIS) due to large vessel occlusion (LVO). Super large bore (SLB) catheters represent the latest evolution in device design for aspiration technology; however, their benefit over standard large bore (LB) catheters remains uncertain.Methods A systematic literature search and proportional meta-analysis were conducted on studies reporting EVT outcomes with LB and SLB aspiration catheters. Both single-arm and comparative studies were included. The primary outcome was first-pass modified treatment in cerebral infarction (mTICI) score ≥2C (FPE2C). Secondary outcomes included safety and procedural measures. Random-effects models generated pooled estimates, with subgroup comparisons between LB and SLB and sensitivity analyses using leave-one-out and outlier exclusion.Results A total of 3966 patients (39 studies) were included in the primary analyses (SLB n=376; LB n=3590). FPE2C rates were similar between SLB and LB catheters (56% vs 50%; P=0.4). Final successful recanalization rates were high and similar in both groups (92% vs 92%; P=0.9). Procedural time did not differ, with pooled mean times of 27.03 min for SLB and 26.97 min for LB catheters. The need for rescue therapy showed a trend toward lower use with SLB compared with LB catheters (11% vs 20%; P=0.06). Rates of failure to reach the target clot showed a trend toward higher rates in the SLB group (10% vs 5%; P=0.11). Safety outcomes did not differ significantly (P>0.2).Conclusion SLB catheters did not demonstrate a clear advantage over LB catheters in reperfusion outcomes. Limited clinical data prevent conclusions on functional benefit, and further prospective studies are needed.",
  "authors": [
    {
      "affiliations": [
        "Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA"
      ],
      "name": "Ariana Chacon"
    },
    {
      "affiliations": [
        "Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA"
      ],
      "name": "Layth JM Saada"
    },
    {
      "affiliations": [
        "Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA"
      ],
      "name": "Dareen Hijazi"
    },
    {
      "affiliations": [
        "Neurology, The University of Tennessee Health Science Center, Memphis, Tennessee, USA"
      ],
      "name": "Madhu Jatty"
    },
    {
      "affiliations": [
        "Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, Georgia, USA"
      ],
      "name": "Tianwen Ma"
    },
    {
      "affiliations": [
        "Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee, USA"
      ],
      "name": "Luke Silveira"
    },
    {
      "affiliations": [
        "Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee, USA"
      ],
      "name": "Lucas Elijovich"
    },
    {
      "affiliations": [
        "Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee, USA"
      ],
      "name": "Violiza Inoa-Acosta"
    },
    {
      "affiliations": [
        "Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee, USA",
        "Neurosurgery, Semmes-Murphey Neurologic and Spine Clinic, University of Tennessee Health Science Center, Memphis, Tennessee, USA"
      ],
      "name": "Christopher Nickele"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, University of Utah Health, Salt Lake City, Utah, USA"
      ],
      "name": "Ramesh Grandhi"
    },
    {
      "affiliations": [
        "Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA",
        "Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA"
      ],
      "name": "Brian M Howard"
    },
    {
      "affiliations": [
        "Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA",
        "Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA"
      ],
      "name": "Jonathan A Grossberg"
    },
    {
      "affiliations": [
        "Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA",
        "Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee, USA"
      ],
      "name": "Ali M Alawieh"
    },
    {
      "affiliations": [
        "Neurology, The University of Tennessee Health Science Center, Memphis, Tennessee, USA",
        "Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee, USA"
      ],
      "name": "Nitin Goyal"
    }
  ],
  "title": "Large bore versus super large bore aspiration catheters in mechanical thrombectomy: a systematic review and meta-analysis",
  "uid": "244c9d18-15d2-5230-86f7-df475c681751"
}