Stroke treatment: UB professor is a leader of trial that finds aspiration-based thrombectomy alone works to treat large vessel occlusion

BUFFALO, N.Y. — More evidence that aspiration-based thrombectomy is a safe and effective alternative for patients with acute ischemic stroke was presented today when preliminary results from the COMPASS trial were featured in the main event plenary session at the International Stroke Conference in Los Angeles.

The independent, prospective, multi-center, randomized trial was led by a team of three investigators: Adnan Siddiqui, MD, PhD, professor of neurosurgery in the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, medical director of neurosurgical stroke service, Kaleida Health, and chief medical officer at the Jacobs Institute; Aquilla S. Turk, DO, the trial’s principal investigator and director of the neurointerventional surgery section in the departments of Radiology and Neurosurgery at the Medical University of South Carolina; and J. Mocco, MD, vice chair of neurosurgery and director of the Cerebrovascular Center at the Icahn School of Medicine at Mt. Sinai.

COMPASS was funded by Penumbra, a global health care company focused on innovative therapies.

The study enrolled 270 patients at 20 centers in the U.S. including Kaleida Health’s Gates Vascular Institute where Elad Levy, MD, L. Nelson Hopkins III Professor of Neurosurgery and chair of the Department of Neurosurgery in the Jacobs School, 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,” Siddiqui said.  “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 in JAMA Neurology earlier this month 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 see patients at UBMD Neurosurgery.