{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T06:01:57Z","timestamp":1792735317929,"version":"4.5.0"},"reference-count":30,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2025,12,22]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Recent advances in mechanical thrombectomy for large vessel occlusion suggest that cyclical aspiration (CyA) may enhance clot ingestion and reduce embolic complications compared with static aspiration (StA). We aimed to identify the experimental conditions under which CyA outperforms StA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A 3D-printed neurovascular model in a flow loop (137\/89\u2009mmHg, 72 bpm) simulated middle cerebral artery M1 segment (MCA-M1) occlusions with soft and stiff clot analogs. CyA (4.5\u2009Hz and \u0394p=85\u2013105\u2009kPa) was performed with a dual-solenoid device coupled to a vacuum pump. Eighty experiments were randomized into four treatment arms combining aspiration patterns and 0.071\u2033 and 0.088\u2033 aspiration catheters: CyA-71, CyA-88, StA-71, and StA-88.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The overall first pass recanalization (FPR) rate was 74% (59\/80), with CyA significantly outperforming StA (92% vs 55%, p&lt;0.001). CyA achieved the highest FPR with both 0.088\u2033 and 0.071\u2033 catheters (95% and 90%, respectively), whereas StA-71 achieved 80% and StA-88 30%.<\/jats:p>\n                    <jats:p>Induction of vessel collapse markedly reduced FPR rates (86.2% without collapse vs 20% with collapse, p&lt;0.001). Under StA, collapse was more frequent with larger catheters (StA-088: 70% vs StA-71: 0%, p&lt;0.001), but CyA significantly mitigated this effect (StA-88: 70% vs CyA-88: 5%, p&lt;0.05). No significant differences were found in distal embolization rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>0.088\u2033 catheters may be more effective for retrieving clots, except in cases of arterial collapse. CyA improves recanalization rates by reducing the risk of collapse associated with super-large bore catheters. A deeper understanding of catheter sizing and neurovascular anatomy could further optimize outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jnis-2025-024554","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T18:20:36Z","timestamp":1767982836000},"page":"jnis-2025-024554","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["\u201cIs larger always better?\u201d An in vitro comparison of cyclical and static aspiration with different catheters in a neurovascular flow model"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6604-3628","authenticated-orcid":false,"given":"Ariel","family":"Paredes Cruz","sequence":"first","affiliation":[{"name":"Stroke Research, Vall d\u2019Hebron Research Institute, Barcelona, Spain"},{"name":"Departament de Medicina, Universitat Aut\u00f2noma de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4278-8222","authenticated-orcid":false,"given":"Jiahui","family":"Li","sequence":"additional","affiliation":[{"name":"Stroke Research, Vall d\u2019Hebron Research Institute, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6108-7977","authenticated-orcid":false,"given":"Magda","family":"Jab\u0142o\u0144ska","sequence":"additional","affiliation":[{"name":"Stroke Research, Vall d\u2019Hebron Research Institute, Barcelona, Spain"},{"name":"2nd Department of Radiology, Medical University of Gda\u0144sk, Gda\u0144sk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1296-3731","authenticated-orcid":false,"given":"Riccardo","family":"Tiberi","sequence":"additional","affiliation":[{"name":"Stroke Research, Vall d\u2019Hebron Research Institute, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6133-0788","authenticated-orcid":false,"given":"Cristina","family":"M\u00e1rquez Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Stroke Research, Vall d\u2019Hebron Research Institute, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9242-043X","authenticated-orcid":false,"given":"Marc","family":"Ribo","sequence":"additional","affiliation":[{"name":"Stroke Research, Vall d\u2019Hebron Research Institute, Barcelona, Spain"},{"name":"Departament de Medicina, Universitat Aut\u00f2noma de Barcelona, Barcelona, Spain"},{"name":"Stroke Unit, Neurology, Vall d\u2019Hebron University Hospital, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,1,9]]},"reference":[{"key":"2026010910202996000_jnis-2025-024554v1.1","doi-asserted-by":"publisher","DOI":"10.1177\/17474930211065917"},{"key":"2026010910202996000_jnis-2025-024554v1.2","doi-asserted-by":"publisher","DOI":"10.1111\/ijs.12480"},{"key":"2026010910202996000_jnis-2025-024554v1.3","doi-asserted-by":"crossref","first-page":"105566","DOI":"10.1016\/j.jstrokecerebrovasdis.2020.105566","article-title":"Comparison Between Three Commonly Used Large-Bore Aspiration Catheters in Terms of Successful Recanalization and First-Passage Effect","volume":"30","author":"Semeraro","year":"2021","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"2026010910202996000_jnis-2025-024554v1.4","doi-asserted-by":"crossref","unstructured":"Mokin M , Grossberg JA , Tomalty D , et al . Abstract 001: Aspiration with super\u2010large bore 0.088 ID catheters in patients with acute ischemic stroke: The final results of an FDA\u2010approved trial. 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Comparison of vacuum pressures and suction forces generated by different pump systems for aspiration thrombectomy. 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