ArticleStroke and vascular neurology2021
Impact of aspiration catheter size on first-pass effect in the combined use of contact aspiration and stent retriever technique.
Article in Stroke and vascular neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- Efficacy of the Route 92 reperfusion system in acute ischemic stroke due to large vessel occlusion: a systematic review and meta-analysis.Neurosurgical review · 2026Pooled it
- Aspiration versus stent retriever for posterior circulation stroke: A meta-analysis.CNS neuroscience & therapeutics · 2023Pooled it
- Effect of Intravenous Tirofiban Versus Placebo on First-Pass Successful Reperfusion in Endovascular Stroke Thrombectomy: Insights From the RESCUE BT Randomized Clinical Trial.Journal of the American Heart Association · 2024Trial
- Partial (SAVE) versus Complete (Solumbra) Stent Retriever Retraction Technique for Mechanical Thrombectomy: A Randomized In Vitro Study.AJNR. American journal of neuroradiology · 2023Trial
- Association Between Occluded Vessel Diameter and Clinical Outcomes of Mechanical Thrombectomy for M2 Occlusion.Clinical neuroradiology · 2026Article
- Why Is a Large-Bore Catheter Necessary in Large Vessel Occlusion from a Biomechanical Perspective?Journal of Korean Neurosurgical Society · 2026Article
- The Aristotle 18 and 24 microwires in neuroIntervention: Early experience at a single centre.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2026Article
- Improved catheter delivery for aspiration thrombectomy using Tenzing 7 ledge reducing catheter and FreeClimb 70.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2026Article
- Computational fluid dynamics assessment of altered hemodynamics in the Circle of Willis during acute ischemic stroke and the impact of cerebral collateral development.Biomechanics and modeling in mechanobiology · 2026Article
- Balancing flow arrest and aspiration: The relationship between balloon guide catheters, large-bore aspiration, and first pass effect in mechanical thrombectomy.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025Article
- MillipedeInterventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025Article
- Does endovascular thrombectomy using super-bore 0.088" large distal platform offer advantages over balloon guide catheters in acute ischemic stroke secondary to large vessel occlusion?Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025Article
- Impact of next-generation delivery assist catheters and crossing strategy on reperfusion success in aspiration thrombectomy.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025Article
- Placing the balloon-guide catheter in the high cervical segment of the internal carotid artery is associated with improved recanalization.Journal of neurointerventional surgery · 2025Article
- The ASCEND Technique-A Modified Direct Aspiration First Pass Technique for a Faster and Cost-effective Mechanical Thrombectomy.Clinical neuroradiology · 2025Article
- "The microcatheter contrast injection technique": A novel technique to detect the proximal end of a thrombus in mechanical thrombectomy.The neuroradiology journal · 2025Article
- Contribution of Large Bore Aspiration Catheter to Mechanical Thrombectomy.Journal of neuroendovascular therapy · 2025Article
- Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2024Article
- First-Pass Effect in M1-Occlusion Stroke Patients Treated with Combined Stent-Retriever/Large-Bore Distal Aspiration Catheter Thrombectomy.Clinical neuroradiology · 2023Article
- Effect of proximal blood flow arrest during endovascular thrombectomy (ProFATE): Study protocol for a multicentre randomised controlled trial.European stroke journal · 2023Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeThe first-pass effect (FPE), defined as a first-pass Expanded Treatment in Cerebral Ischaemia (eTICI) 2c/3 reperfusion, has emerged as a key metric of efficacy in mechanical thrombectomy (MT) for acute ischaemic stroke. The proximal balloon occlusion together with direct thrombus aspiration during stent retriever thrombectomy (PROTECT)-PLUS technique consists in the use of a balloon guide catheter and a combined MT approach involving contact aspiration and a stent retriever. The aim of this study is to assess the effectiveness and safety of the PROTECT-PLUS technique using distal aspiration catheters (DACs) with different inner diameters by comparing the large-bore DAC Catalyst 7 versus the use of medium-bore DACs.
methodsRetrospective analysis of a prospectively maintained database of patients treated with PROTECT-PLUS using Catalyst 7, Catalyst 6 or Catalyst 5 with an occlusion of either the terminal carotid artery or the M1 or M2 segments of the middle cerebral artery from 2018 to 2020 in two comprehensive stroke centres. Baseline characteristics and procedural, safety and clinical outcomes were compared between groups. Multivariable logistic regression analysis was performed in order to find independent predictors of FPE.
resultsWe identified 238 consecutive patients treated with PROTECT-PLUS as front-line approach using Catalyst 7 (n=86), Catalyst 6 (n=78) and Catalyst 5 (n=76). The rate of FPE was higher with Catalyst 7 (54%) than Catalyst 6 (33%, p=0.009) and Catalyst 5 (32%, p=0.005), in addition to higher final eTICI 2c/3 reperfusion rates, shorter procedural times, lower need of rescue therapy and fewer procedure-related complications. After multivariable analysis the sole independent factor associated to FPE was the use of Catalyst 7 (OR 2.34; 95% CI 1.19 to 4.58; p=0.014).
conclusionFurther development of combined MT by incorporating larger-bore aspiration catheters is associated with higher reperfusion rates, shorter procedure times, and lower need of rescue therapy while reducing the complication rates.
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