{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T00:47:19Z","timestamp":1787359639390,"version":"build-2736575974"},"reference-count":21,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2026,3,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Combined delivery catheter systems (CDCS) with ledge-reducing obturators are designed to streamline aspiration-first mechanical thrombectomy, yet comparative multicenter data across platforms remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine whether an aspiration-first CDCS strategy improves procedural efficiency without compromising angiographic success or safety compared with traditional aspiration systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multicenter, retrospective cohort study was conducted using prospectively maintained registries of consecutive aspiration-first thrombectomies at three comprehensive stroke centers in the United States (June 2023\u2013January 2025). CDCS (Route 92 FreeClimb 70-Tenzing, Penumbra RED 72-SENDit, Balt Carrier, Q\u2019Apel Hippo-Cheetah) were compared with conventional microcatheter-guided aspiration. Primary outcome was groin-to-final-reperfusion time. Secondary outcomes included first-pass and final extended Thrombolysis in Cerebral Infarction (eTICI)\u22652b reperfusion, number of passes, fluoroscopy time, symptomatic intracranial hemorrhage, and 90-day modified Rankin Scale scores. Multivariable models were adjusted for prespecified covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The primary outcome, groin-to-final-reperfusion time (26.0 vs 41.0\u2009min, p=0.001), was significantly shorter with CDCS (n=66). Secondary outcomes demonstrated fewer number of passes (1.8\u00b11.3\u2009vs 2.3\u00b11.4, p=0.02), higher first-pass eTICI\u22652b (66.7% vs 44.9%, p=0.009) and final eTICI\u22652b (92.4% vs 78.2%, p=0.02) reperfusion rates, and lower fluoroscopy times (18.8 vs 24.5\u2009min, p=0.02). Symptomatic intracranial hemorrhage occurred in 4.6% of CDCS versus 12.8% of traditional cases (p=0.14). There was no significant difference in 90-day functional outcomes between groups (3.6\u00b11.9\u2009vs 3.5\u00b12.6, p=0.82). Findings remained significant after adjustment where applicable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>An aspiration-first CDCS strategy was associated with faster reperfusion and higher angiographic success without apparent safety trade-offs. Prospective comparative and cost-effectiveness studies are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jnis-2025-024700","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T17:20:30Z","timestamp":1781889630000},"page":"jnis-2025-024700","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Faster reperfusion with combined delivery catheter systems in aspiration-first stroke thrombectomy: a multicenter analysis"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6057-2447","authenticated-orcid":false,"given":"Keiko A","family":"Fukuda","sequence":"first","affiliation":[{"name":"Radiological Sciences, Division of Interventional Neuroradiology, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, California, USA"},{"name":"Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, 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