Route 92 Reperfusion System increases first-pass effect and near-complete reperfusion in acute ischemic strokeRoute 92 System Shows Better Blood Flow in Stroke

Neurosurgical review Published July 9, 2026 Study authors: Elmashad Ahmed, Elfil Mohamed, Hawas Yousef, Sabet Haneen, Albanna Abdalla Jamal, Soldozy Sauson, Sa… PubMed ↗ DOI ↗ Editorial oversight: Dr. Ji-eun Park, MD · Brain, Mind & Pain

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Key Takeaway

Note that Route 92 Reperfusion System shows higher first-pass effect and near-complete reperfusion in AIS-LVO.

This meta-analysis of 7 studies evaluated the efficacy and safety of the Route 92 Reperfusion System for patients with acute ischemic stroke due to large vessel occlusion (AIS-LVO). The analysis compared the system against other techniques, focusing on reperfusion metrics and clinical outcomes.

The study found that the Route 92 Reperfusion System achieved significantly higher first-pass effect (FPE) rates compared to other techniques (RD: 0.18; NNT: 6; p = 0.001). Additionally, near-complete reperfusion was significantly higher with a risk difference of 0.23 and an NNT of 4 (p = 0.0005). Patients achieved functional independence at a rate of 43%, and NIHSS scores improved by a mean difference of -9.55 (p < 0.00001).

Safety data indicated a favorable safety profile with a 3% rate of symptomatic intracranial hemorrhage. While the results suggest high rates of successful reperfusion, the authors note that future randomized controlled trials are warranted to support these findings and provide definitive evidence for clinical practice.

Researchers analyzed data from 490 patients who experienced an acute ischemic stroke caused by a large vessel occlusion. They compared the Route 92 Reperfusion System against other common techniques to see how well it restored blood flow to the brain.

The results showed that the Route 92 system had significantly higher first-pass effect rates and better near-complete reperfusion compared to other methods. Specifically, 56% of patients achieved a first-pass effect, while 94% reached near-complete or complete reperfusion. Additionally, patients saw significant improvements in their NIHSS scores, which measure stroke severity.

While the system showed a favorable safety profile, there was a 3% rate of symptomatic intracranial hemorrhage. Because this study is a meta-analysis and not a randomized controlled trial, more research is needed to confirm these results. Patients should discuss these findings with their doctors to see if this specific technology is appropriate for their treatment plan.

What this means for you:

The Route 92 system shows higher rates of successful blood flow restoration in large vessel strokes.

Common questions

How effective is the Route 92 system at restoring blood flow?

The study found that the Route 92 Reperfusion System achieved significantly higher first-pass effect rates compared to other techniques. In the analysis, 56% of patients achieved a first-pass effect, and 94% achieved near-complete to complete reperfusion.

Is the Route 92 system safe for stroke patients?

The system was reported to have a favorable safety profile. However, there was a 3% rate of symptomatic intracranial hemorrhage (sICH) among the patients studied. You should talk to your doctor about specific risks.

How did the Route 92 system affect stroke severity scores?

Patients treated with the Route 92 Reperfusion System showed significant improvements in their NIHSS scores, which are used to measure the severity of a stroke. The mean difference in these scores was -9.55.

Study Details

Study typeMeta analysis

Sample sizen = 490

EvidenceLevel 1

PublishedJul 2026

PMID42418028

View Original Abstract ↓

Super large-bore aspiration catheters have emerged as promising tools for endovascular thrombectomy (EVT) in acute ischemic stroke (AIS) due to large vessel occlusion (LVO). The Route 92 Reperfusion System utilizes super large-bore catheters with specialized delivery mechanisms to maximize first-pass effect (FPE) and reperfusion rates. To evaluate the efficacy and safety of the Route 92 super large bore reperfusion System in treating AIS-LVO. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched five databases from inception through December 2025. Studies evaluating Route 92 Reperfusion System outcomes in AIS-LVO patients were included. Primary outcomes were FPE and functional independence (modified Rankin Scale (mRS) 0-2). Secondary outcomes included successful reperfusion (modified thrombolysis in cerebral infarction (mTICI) scores), symptomatic intracranial hemorrhage (sICH), mortality, and adverse events. Random-effects models were used for all analyses. Seven studies comprising 490 patients were included. In comparative analyses, Route 92 (0.088") demonstrated significantly higher FPE rates (risk difference (RD): 0.18, number needed to treat (NNT) = 6, p = 0.001) and near-complete reperfusion (RD: 0.23, NNT = 4, p = 0.0005) compared to other techniques. Single-arm analyses showed 56% achieved FPE, 94% achieved near-complete to complete reperfusion, and 43% achieved functional independence at follow-up. The system demonstrated favorable safety with 3% sICH rate and 20% mortality. National Institutes of Health Stroke Scale (NIHSS) scores improved significantly (mean difference (MD): -9.55, p < 0.00001). The Route 92 Reperfusion System achieves high rates of FPE and successful reperfusion with acceptable safety profiles. Future RCTs is warranted to support these findings.

Route 92 Reperfusion System increases first-pass effect and near-complete reperfusion in acute ischemic strokeRoute 92 System Shows Better Blood Flow in Stroke

Common questions

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Route 92 Reperfusion System increases first-pass effect and near-complete reperfusion in acute ischemic strokeRoute 92 System Shows Better Blood Flow in Stroke

Common questions

More on Stroke

Study Details

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Clinical research that matters. Delivered to your inbox.

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