First-Line Contact Aspiration vs. Stent Retriever for Acute Large-Vessel Ischemic Stroke

Most patients in recent mechanical thrombectomy trials were treated with stent retrievers. But the large-bore catheter that is required to deploy a stent retriever also provides ready access for direct clot aspiration. A strategy of first-line clot aspiration could obviate the need to use a stent retriever in many cases and could facilitate earlier and more effective recanalization.

Investigators conducting the foundation- and industry-funded Contact Aspiration vs. Stent Retriever for Successful Revascularization trial (ASTER) at eight French stroke centers tested this theory. They randomized 381 acute stroke patients with anterior circulation large-vessel occlusion to two recanalization strategies: first-line contact aspiration or first-lin…