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In reply: Is aspiration first-pass technique a better choice in mechanical thrombectomy for large vessel occlusions?
  1. Vance L Fredrickson,
  2. Andrew F Ducruet
  1. Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
  1. Correspondence to Dr Andrew F Ducruet, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ 85013, USA; Neuropub{at}

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The Authors' reply:

We thank Sun and Meng for submitting their letter1 regarding our recent publication in JNIS, which described a single-center, single-operator study comparing radiographic outcomes between patients treated with stentriever-first versus aspiration-first approaches for mechanical thrombectomy for large vessel occlusion stroke.2 We appreciate the opportunity to respond to this letter to frame our paper in the context of the ongoing debate regarding the choice of techniques for mechanical thrombectomy.

Our study was initially conceived to compare angiographic reperfusion attained using various stentrievers used by the senior author in the 2018 calendar year. During the study period, we preferentially applied a stentriever-first approach, although in combination with local aspiration. This preference was due in part to the preponderance of class 1 data and corresponding American Heart Association guidelines supporting the use of stentrievers for the treatment of large vessel occlusion stroke. Indeed, the senior author used a stentriever-first approach in 78.5% of his mechanical thrombectomy cases in 2018. To incorporate all consecutive cases performed during the study period, we also included cases in which we performed manual aspiration as …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests AFD is a consultant for Penumbra, Medtronic, Cerenovus, Stryker, and Koswire. All other authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this manuscript

  • Provenance and peer review Not commissioned; internally peer reviewed.

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