Passive Advancement of the Aspiration Catheter During Mechanical Thrombectomy is Independently Associated with Superior Recanalization Outcomes

The study examined passive advancement of the aspiration catheter (its forward movement without active operator force) during mechanical thrombectomy in 995 patients with 1,027 occlusions. Passive advancement occurred in 71.6% of cases, with advancement to an arterial branch point in 41.7% of cases. Patients with passive advancement achieved successful recanalization in 71% of cases compared to 19.7% without this phenomenon. When the catheter advanced to an arterial branch point, success rate reached 90.5%. Passive advancement was also associated with lower rates of secondary occlusion (13.3% versus 31.3%). The results demonstrate that passive advancement is an independent predictor of successful recanalization and should be a technical objective of aspiration thrombectomy.