{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T22:36:58Z","timestamp":1780526218112,"version":"3.54.1"},"reference-count":9,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T00:00:00Z","timestamp":1752019200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Optimal stent retriever diameter for mechanical thrombectomy in large vessel occlusion remains debated. We compared the efficacy and safety of Solitaire 4\u202f\u00d7\u202f40\u202fmm and 6\u202f\u00d7\u202f40\u202fmm stent retrievers in treating distal internal carotid artery (ICA) or middle cerebral artery (MCA) M1 segment occlusion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively analyzed 145 patients with distal ICA or M1 occlusion treated with the Solitaire 4\u202f\u00d7\u202f40\u202fmm (<jats:italic>n<\/jats:italic>\u202f=\u202f59) or 6\u202f\u00d7\u202f40\u202fmm (<jats:italic>n<\/jats:italic>\u202f=\u202f86) devices. The primary outcome was the rate of first-pass modified thrombolysis in cerebral infarction (mTICI)\u202f\u2265\u202f2b without rescue therapy. Secondary outcomes included the number of passes to achieve mTICI \u22652b, device switching and distal embolization rates, and safety parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The 6\u202f\u00d7\u202f40\u202fmm group displayed a significantly higher first-pass mTICI \u22652b rate (58.1% vs. 23.7%, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001), a lower number of passes to achieve successful revascularization (1.67\u202f\u00b1\u202f1.00 vs. 2.54\u202f\u00b1\u202f1.19, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001), and lower rates of device switching (4.7% vs. 18.6%, <jats:italic>p<\/jats:italic>\u202f=\u202f0.015) and distal embolization (8.1% vs. 25.4%, <jats:italic>p<\/jats:italic>\u202f=\u202f0.009). Postprocedural hemorrhage was less frequent in the 6\u202f\u00d7\u202f40\u202fmm group (55.8% vs. 76.3%, <jats:italic>p<\/jats:italic>\u202f=\u202f0.039), whereas symptomatic hemorrhage rates were similar between the groups (5.8% vs. 5.1%, <jats:italic>p<\/jats:italic>\u202f&amp;gt;\u202f0.999).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The Solitaire 6\u202f\u00d7\u202f40\u202fmm stent retriever showed more favorable efficacy outcomes and comparable safety compared to the 4\u202f\u00d7\u202f40\u202fmm device for distal ICA or M1 occlusion, suggesting it may be considered a preferred option for these vessels.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2025.1618737","type":"journal-article","created":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T05:45:57Z","timestamp":1752126357000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of stent retriever diameter on clinical outcomes in mechanical thrombectomy: a multicenter comparison of the 4-mm and 6-mm Solitaire devices"],"prefix":"10.3389","volume":"16","author":[{"given":"Jung Hyun","family":"Park","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hoon","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunghan","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1159\/000501080","article-title":"Understanding the radial force of stroke Thrombectomy devices to minimize Vessel Wall injury: mechanical bench testing of the radial force generated by a novel braided Thrombectomy assist device compared to laser-cut stent retrievers in simulated MCA vessel diameters","volume":"8","author":"Katz","year":"2020","journal-title":"Interv Neurol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1136\/neurintsurg-2015-012213","article-title":"Experimental evaluation of stent retrievers' mechanical properties and effectiveness","volume":"9","author":"Machi","year":"2017","journal-title":"J Neurointerv Surg"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1161\/STROKEAHA.118.022987","article-title":"Impact of stent retriever size on clinical and angiographic outcomes in the STRATIS stroke Thrombectomy registry","volume":"50","author":"Zaidat","year":"2019","journal-title":"Stroke"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1159\/000499974","article-title":"Longer 6-mm diameter stent retrievers are effective for achieving higher first pass success with fibrin-rich clots","volume":"8","author":"Girdhar","year":"2020","journal-title":"Interv Neurol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1136\/neurintsurg-2018-013918","article-title":"Longer stent retrievers enhance thrombectomy performance in acute stroke","volume":"11","author":"Haussen","year":"2019","journal-title":"J Neurointerv Surg"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"679402","DOI":"10.3389\/fneur.2021.679402","article-title":"First-pass reperfusion by mechanical Thrombectomy in acute M1 occlusion: the size of retriever matters","volume":"12","author":"Serna Candel","year":"2021","journal-title":"Front Neurol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1586","DOI":"10.3174\/ajnr.A5232","article-title":"Effect of retrievable stent size on endovascular treatment of acute ischemic stroke: a multicenter study","volume":"38","author":"Yang","year":"2017","journal-title":"AJNR Am J Neuroradiol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1016\/j.wneu.2017.08.043","article-title":"Single-center experience of mechanical Thrombectomy with the Trevo XP ProVue 6 x 25 mm stent retriever in middle cerebral artery occlusion: comparison with Trevo XP ProVue 4 x 20 mm","volume":"107","author":"Yi","year":"2017","journal-title":"World Neurosurg"},{"key":"ref9","year":"2024"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1618737\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T12:13:29Z","timestamp":1752149609000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1618737\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,9]]},"references-count":9,"alternative-id":["10.3389\/fneur.2025.1618737"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2025.1618737","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,9]]},"article-number":"1618737"}}