Carrier-assisted mechanical thrombectomy showed shorter puncture-to-clot times and maintained safety in stroke patientsCarrier catheter may speed clot removal in stroke patients

This multicenter retrospective study evaluated 211 carrier-assisted mechanical thrombectomies (Carrier DAC) performed at 15 U.S. Comprehensive Stroke Centers. The primary outcomes included puncture-to-clot engagement time and first-pass effect (eTICI 2c-3). Secondary outcomes assessed median puncture-to-reperfusion time, modified first-pass effect, parenchymal hematoma, subarachnoid hemorrhage, and cavernous tortuosity effects.

The main results showed a median puncture-to-clot time of 12 minutes. The first-pass effect occurred in 50.7% of cases, while the modified first-pass effect was observed in 74.4%. Hemorrhagic complications included parenchymal hematoma in 11.8% of patients and subarachnoid hemorrhage in 6.6%. Super-bore catheter use was noted in 5.7% of cases. A single-center analysis of 242 patients compared upfront contact aspiration using Carrier DAC versus standard 0.021-inch microcatheter techniques.

In the single-center analysis, puncture-to-clot times were shorter with Carrier use, and first-pass effect rates were numerically higher. Hemorrhagic complications were not increased with Carrier use. The cavernous tortuosity effect did not affect primary endpoints. Safety data indicated tolerability was not reported, and discontinuations were not reported. Serious adverse events were not reported.

Key limitations include that multicenter data remain limited and prospective studies are warranted. The study design prevents causal conclusions. Practice relevance suggests Carrier DAC enables efficient navigation of large-bore aspiration catheters and may reduce procedural time while maintaining procedural safety. Funding or conflicts of interest were not reported.