Published January 29, 2018
Adnan Siddiqui, MD, PhD, vice chair and professor of neurosurgery and one of the lead investigators in the COMPASS trial, presented preliminary results at the International Stroke Conference in Los Angeles that show evidence that aspiration-based thrombectomy is a safe and effective alternative for patients with acute ischemic stroke.
The independent, prospective, multi-center, randomized trial enrolled 270 patients at 20 centers in the U.S., including Kaleida Health’s Gates Vascular Institute (GVI) where Elad I. Levy, MD, L. Nelson Hopkins III, MD, Professor and Chair of the Department of Neurosurgery, was the local principal investigator.
It compared mechanical thrombectomy to stent retrievers. Instead of mechanically removing the clot by catching it in the wire mesh cage of the stent retriever, aspiration involves threading a catheter into the brain that then attempts to remove the clot through suction alone.
“This trial provides clear evidence that new large catheters that can aspirate the clot are as good as stent retrievers which pull the clot out in blocked vessels causing acute ischemic stroke,” says Siddiqui, who is also chief medical officer of the Jacobs Institute and director of the Toshiba Stroke & Vascular Research Center at UB’s Clinical Translational Research Center.
“The results achieved were fantastic for both interventional strategies, as were the outcomes and safety profiles. This study provides level 1 evidence that using large bore aspiration catheters as a first line strategy is a valid approach in treating patients with large vessel acute ischemic stroke.”
The findings are especially significant, he said, coming soon after the publication of a paper in JAMA Neurology in early January by Siddiqui and Levy. That trial found that in many cases of large vessel occlusion — among the most severe types of stroke — the use of a stent retriever may not always be necessary.
Siddiqui and Levy, who is also director of endovascular stroke treatment and research and medical director of neuroendovascular services at GVI, see patients at UBMD Neurosurgery.
Besides Siddiqui, other lead investigators on the COMPASS trial are:
COMPASS was funded by Penumbra, a global health care company focused on innovative therapies.