Introduction Endovascular treatment of acute ischemic stroke has evolved greatly in recent years and its benefits have been analyzed in several recent publications.

The advancement of technology has allowed the development of new large bore thrombectomy catheters that provide safe intracranial navigation and efficient aspiration. We report an initial experience with the ACE and ACE64 aspiration thrombectomy catheters using the direct aspiration first pass technique in large proximal arterial occlusions.

Material and methods We conducted a retrospective case series analysis of patients with acute ischemic stroke treated endovascularly with the ACE/ACE64 reperfusion catheter.

We reviewed all patients treated in our institution with this catheter by first intention since the catheter has been available. Baseline and procedural characteristics were collected and analyzed.

Results From 1st April 2014 when the 5ACE catheter became available until now, we have treated 55 strokes endovascularly with the ACE/ACE64 reperfusion catheters. 59% of patients received IV rtPA prior to endovascular treatment, while the remaining 41% did not due to IV therapy contraindication. Of these patients 36 (65.4%) were treated with aspiration only, 17 (31%) with aspiration and stent retriever and 2 (3.6%) with aspiration associated with angioplasty and stent; the latter two cases involved a patient with a carotid artery tandem lesion and another patient with a basilar artery thrombosis. There were no technical complications, but two asymptomatic perforations occurred.

Recanalization of the artery (TICI 2b / 3) was achieved in 96.4% of the cases, which was not possible in 2 patients (3.6%).

The median time from symptom onset to recanalization was 5 hrs 26 min and the mean time from puncture to recanalization was 57 min.

To date, there are 3-month reviews available for 39 patients, of whom 64% present good functional outcome of mRS ≤2.

Conclusion In our initial experience, the ACE/ACE64 reperfusion catheters provide a safe and effective tool for the treatment of acute ischemic stroke using direct aspiration, in which we were able to recanalize (TICI 2B/3) 96.4% of cases, achieving good clinical results.

Disclosures P. Navia: None. J. Massó: None. J. Larrea: None. E. Pardo: None.