{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:13:22Z","timestamp":1786979602918,"version":"build-2736575974"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100008375","name":"University of Basel","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100008375","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Neuroradiol"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Techniques for endovascular thrombectomy in acute ischemic stroke due to medium or distal vessel occlusions (MDVO) need to be improved, and first-line aspiration is emerging as a\u00a0promising technique. The objective was to describe first-pass and final reperfusion rates with a\u00a0triaxial direct aspiration first pass technique (ADAPT) and a\u00a0novel, quadriaxial technique (QUATTRO-ADAPT) using RED43 Reperfusion Catheters to target MDVOs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study collected data from 11\u00a0stroke centers in Europe and North America between 2023 and 2025. Patients with primary, isolated MDVOs who underwent thrombectomy using first-line aspiration with RED43 Reperfusion Catheters were included. Primary outcome was first-pass successful reperfusion rate (modified Treatment In Cerebral Infarction score \u2265\u202f2b). Additionally, final reperfusion rates, complications and functional outcomes up to 90\u00a0days were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 85\u00a0cases. Median age was 74\u00a0years (IQR 67\u201381) and median National Institutes of Health Stroke Scale score\u00a09 (IQR 6\u201315). The majority (69.4%) had an occlusion of the co- or nondominant M2 segment of the middle cerebral artery. First-pass successful reperfusion was 63.5% overall, with 55.6% for the triaxial ADAPT and 69.4% for the quadriaxial QUATTRO-ADAPT. Final successful reperfusion was achieved in 96.5%. Complications included vessel perforations (2.4%), subarachnoid hemorrhage (3.5%), parenchymal hematoma type\u00a02 (2.4%), and symptomatic intracerebral hemorrhage (1.2%). Functional independence (modified Rankin Scale\u00a00\u20132) at 90\u00a0days was observed in 58.7%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study shows that first-line aspiration, especially in a\u00a0quadriaxial approach, can be effective and safe. These findings should be evaluated in prospective trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00062-025-01567-8","type":"journal-article","created":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T18:13:17Z","timestamp":1759169597000},"page":"185-194","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["First-line Aspiration Thrombectomy with the RED43 Catheter for Acute Ischemic Stroke due to Medium or Distal Vessel 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J.M.\u00a0Cappuzzo: Honorarium for Training from and Consultant for Medtronic, Penumbra, Q\u2019Apel Medical Inc.. J.\u00a0Beecher: Consultant for Penumbra, Medtronic, Providence Medical, Aesculap Surgical Equipment. C.\u00a0Matouk: Consultant for Penumbra, Terumo Neurovascular, Silk Road Medical and has stock options of CereVasc and Jiva Medical. D.\u00a0Volders: Consultant for Penumbra. J.\u00a0Wass\u00e9lius: Founder and shareholder of Uman Sense AB, Speaker fees from Siemens Healthineers, Balt Group and Medtronic. M.\u00a0Heran: Speaker fees from Penumbra, Siemens and Sim&Cure, Consultant for Balt, Stryker, Microvention, Phenox and Medtronic and is Advisory Board member of Oruen. M.\u00a0Schl\u00f6sser: Consultant for Balt, Speaker fees from Penumbra. S.\u00a0Meckel: Consultant for Acandis, Balt and Medtronic, Speaker fees from Balt, Medtronic, Penumbra and is member of the scientific advisory board \u201cTitAIN Imaging AdBoard\u201d. V.\u00a0Schulze-Zachau: Speaker fees from Medtronic and Grants from Bangerter-Rhyner Foundation and Freiwillige Akademische Gesellschaft Basel. M.\u00a0Psychogios: Grants from the Swiss National Science Foundation (SNF) for the DISTAL trial (33IC30_198783), ICARUS (32003B_220118) and TECNO trial (32003B_204977), Grant from Bangerter-Rhyner Foundation for the DISTAL trial. Unrestricted Grants for the DISTAL trial from Stryker Neurovascular Inc., Medtronic Inc., Phenox GmbH, Penumbra Inc. and Rapid Medical Inc., Sponsor-PI SPINNERS trial (funded by a\u00a0Siemens Healthineers AG Grant), Research agreement with Siemens Healthineers AG, Local PI for the ASSIST, EXCELLENT, TENSION, COATING, SURF and ESCAPE-NEXT trials, Speaker fees from Stryker Neurovascular Inc., Medtronic Inc., Penumbra Inc., Acandis GmbH, Phenox GmbH, Siemens Healthineers AG. V.\u00a0Aebischer, A.\u00a0Brehm, N.\u00a0Rommers, M.\u00a0Sowlat, K.\u00a0Raghuram, A.\u00a0Amllay, A.\u00a0Rohr, P.J.\u00a0Mosimann, M.\u00a0Al-Tibi, B.M.\u00a0Hansen, M.\u00a0Holtmannsp\u00f6tter, O.\u00a0Aoua, S.\u00a0Giragani, A.\u00a0Boghi, N.\u00a0Ntoulias, I.\u00a0Tsogkas, K.A.\u00a0Blackham and A.\u00a0Anastasiou declare that they have no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was approved by the ethics committee and is registered with the Project-ID 2025-00139 at Ethics Committee Northwest and Central Switzerland.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical standards"}}]}}