CardioVascular and Interventional Radiology

, Volume 42, Issue 1, pp 110–115 | Cite as

Endovascular Stroke Therapy with a Novel 6-French Aspiration Catheter

  • M. Bretzner
  • L. Estrade
  • M. Ferrigno
  • F. Bala
  • F. Boustia
  • A. Kazemi
  • J. P. Pruvo
  • H. Henon
  • N. BricoutEmail author
Clinical Investigation Stroke/Neurointerventions
Part of the following topical collections:
  1. Stroke/Neurointerventions


Background and Purpose

Direct thrombus aspiration is increasingly used as a first-line therapy in acute ischemic stroke with large vessel occlusion. We assessed the performance and safety of a novel aspiration catheter available: the 6-French AXS Catalyst catheter.

Materials and Methods

We conducted a cohort study from a prospective clinical registry of consecutive stroke patients treated by mechanical thrombectomy between March 2016 and July 2016. Baseline clinical and imaging characteristics, recanalization rates, complications, and clinical outcomes were analyzed.


Among the 60 patients included, 30 were treated using aspiration alone, 14 were treated using aspiration and then stent retriever as a rescue therapy, and 16 were treated using aspiration combined with a stent retriever straightaway. Successful recanalization (mTICI2b/3) was achieved in 85% patients and functional independence in 48.3%. We observed one intracranial perforation and one vertebral artery dissection. Symptomatic intracranial hemorrhage occurred in 5% and mortality in 21.7%.


Endovascular stroke therapy using the AXS Catalyst catheter seems safe and effective, with similar performance than other reperfusion catheters.


Stroke Thrombectomy Catheter 



Acute ischemic stroke


A Direct Aspiration First Pass Technique


Hemorrhagic infarction


Internal carotid artery


Intravenous thrombolysis


Large vessel occlusion


Middle cerebral artery


Mechanical thrombectomy


Modified Thrombolysis In Cerebral Infarction


Parenchymal hemorrhage


Symptomatic intracerebral hemorrhage



This work was supported by Stryker Neurovascular. The funding source was not involved in study design, monitoring, data collection, statistical analyses, interpretation of results, or manuscript writing.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Consent for Publication

Consent for publication was obtained for every individual person’s data included in the study.


  1. 1.
    Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, et al. Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2018. Scholar
  2. 2.
    Lapergue B, Blanc R, Gory B, Labreuche J, Duhamel A, Marnat G, et al. Effect of endovascular contact aspiration vs stent retriever on revascularization in patients with acute ischemic stroke and large vessel occlusion: the ASTER randomized clinical trial. JAMA. 2017;318:443–52.CrossRefGoogle Scholar
  3. 3.
    Turk AS, Frei D, Fiorella D, Mocco J, Baxter B, Siddiqui A, et al. ADAPT FAST study: a direct aspiration first pass technique for acute stroke thrombectomy. J Neurointerv Surg. 2014;6:260–4.CrossRefGoogle Scholar
  4. 4.
    Massari F, Henninger N, Lozano JD, Patel A, Kuhn AL, Howk M, et al. ARTS (aspiration-retriever technique for stroke): initial clinical experience. Interv Neuroradiol. 2016;22:325–32.CrossRefGoogle Scholar
  5. 5.
    Maus V, Behme D, Kabbasch C, Borggrefe J, Tsogkas I, Nikoubashman O, et al. Maximizing first-pass complete reperfusion with SAVE. Clin Neuroradiol. 2017;28:1–12.Google Scholar
  6. 6.
    Ferrigno M, Bricout N, Leys D, Estrade L, Cordonnier C, Personnic T, et al. Intravenous recombinant tissue-type plasminogen activator: influence on outcome in anterior circulation ischemic stroke treated by mechanical thrombectomy. Stroke. 2018;49:1377–85.CrossRefGoogle Scholar
  7. 7.
    Adams HP, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL, et al. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in acute stroke treatment. Stroke. 1993;24:35–41.CrossRefGoogle Scholar
  8. 8.
    Hacke W, Kaste M, Fieschi C, von Kummer R, Davalos A, Meier D, et al. Randomised double-blind placebo-controlled trial of thrombolytic therapy with intravenous alteplase in acute ischaemic stroke (ECASS II). Second European-Australasian Acute Stroke Study Investigators. Lancet Lond Engl. 1998;352:1245–51.CrossRefGoogle Scholar
  9. 9.
    van Swieten JC, Koudstaal PJ, Visser MC, Schouten HJ, van Gijn J. Interobserver agreement for the assessment of handicap in stroke patients. Stroke. 1988;19:604–7.CrossRefGoogle Scholar
  10. 10.
    Neeb L, Villringer K, Galinovic I, Grosse-Dresselhaus F, Ganeshan R, Gierhake D, et al. Adapting the computed tomography criteria of hemorrhagic transformation to stroke magnetic resonance imaging. Cerebrovasc Dis Extra. 2013;3:103–10.CrossRefGoogle Scholar
  11. 11.
    Zaidat OO, Yoo AJ, Khatri P, Tomsick TA, von Kummer R, Saver JL, et al. Recommendations on angiographic revascularization grading standards for acute ischemic stroke: a consensus statement. Stroke. 2013;44:2650–63.CrossRefGoogle Scholar
  12. 12.
    Togay-Işikay C, Kim J, Betterman K, Andrews C, Meads D, Tesh P, et al. Carotid artery tortuosity, kinking, coiling: stroke risk factor, marker, or curiosity? Acta Neurol Belg. 2005;105:68–72.PubMedGoogle Scholar
  13. 13.
    Goyal M, Menon BK, Van Zwam WH, Dippel DW, Mitchell PJ, Demchuk AM, et al. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet. 2016;387:1723–31.CrossRefGoogle Scholar
  14. 14.
    Quinn TJ, Taylor-Rowan M, Coyte A, Clark AB, Musgrave SD, Metcalf AK, et al. Pre-stroke modified rankin scale: evaluation of validity, prognostic accuracy, and association with treatment. Front Neurol. 2017;8:275.CrossRefGoogle Scholar
  15. 15.
    Dobrocky T, Piechowiak E, Cianfoni A, Zibold F, Roccatagliata L, Mosimann P, et al. Thrombectomy of calcified emboli in stroke. Does histology of thrombi influence the effectiveness of thrombectomy? J NeuroInterv Surg. 2018;10:345–50.CrossRefGoogle Scholar
  16. 16.
    Gunning GM, McArdle K, Mirza M, Duffy S, Gilvarry M, Brouwer PA. Clot friction variation with fibrin content; implications for resistance to thrombectomy. J Neurointerv Surg. 2017;10:34–8.CrossRefGoogle Scholar
  17. 17.
    Kidwell CS, Chalela JA, Saver JL, Starkman S, Hill MD, Demchuk AM, et al. Comparison of MRI and CT for detection of acute intracerebral hemorrhage. JAMA. 2004;292:1823–30.CrossRefGoogle Scholar
  18. 18.
    Goyal M, Menon BK, van Zwam WH, Dippel DWJ, Mitchell PJ, Demchuk AM, et al. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet. 2016;387:1723–31.CrossRefGoogle Scholar
  19. 19.
    Vora NA, Gupta R, Thomas AJ, Horowitz MB, Tayal AH, Hammer MD, et al. Factors predicting hemorrhagic complications after multimodal reperfusion therapy for acute ischemic stroke. Am J Neuroradiol. 2007;28:1391–4.CrossRefGoogle Scholar
  20. 20.
    Mocco J, Zaidat OO, von Kummer R, Yoo AJ, Gupta R, Lopes D, et al. Aspiration thrombectomy after intravenous alteplase versus intravenous alteplase alone. Stroke. 2016;47:2331–8.CrossRefGoogle Scholar
  21. 21.
    Blanc R, Redjem H, Ciccio G, Smajda S, Desilles J-P, Orng E, et al. Predictors of the aspiration component success of a direct aspiration first pass technique (ADAPT) for the endovascular treatment of stroke reperfusion strategy in anterior circulation acute stroke. Stroke. 2017;48:1588–93.CrossRefGoogle Scholar
  22. 22.
    Sallustio F, Pampana E, Davoli A, Merolla S, Koch G, Alemseged F, et al. Mechanical thrombectomy of acute ischemic stroke with a new intermediate aspiration catheter: preliminary results. J NeuroInterv Surg. 2018. Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2018

Authors and Affiliations

  1. 1.Department of Interventional NeuroradiologyUniversity of LilleLilleFrance
  2. 2.Department of NeurologyUniversity of LilleLilleFrance
  3. 3.Department of Interventional NeuroradiologyUniversity of ToursToursFrance
  4. 4.INSERM U1171 - Degenerative and Vascular Cognitive DisordersLilleFrance

Personalised recommendations