Canadian Registry Evaluates Aspiration Thrombectomy Using RED‐78 Catheter for Stroke Treatment

Introduction/Purpose Large‐bore aspiration catheters are increasingly deployed for endovascular stroke treatment (EVT), yet high‐quality multicentre data remain limited. This study aimed to evaluate the technical success and safety of the 0.078″ RED‐78 aspiration catheter in routine practice across Canadian stroke centres. Materials/Methods MAPLE‐78 is a prospective quality improvement registry conducted at six comprehensive stroke centres. Between April 2024 and July 2025, consecutive adults with anterior or posterior circulation large vessel occlusion (LVO) eligible for EVT within 24 hours were treated with RED‐78. Baseline demographics, imaging characteristics (occlusion site, vessel diameter, multiphase CTA collateral grade, clot burden score [CBS]), and procedural variables were collected in a prespecified electronic case report form.The primary endpoint was successful reperfusion (eTICI ≥ 2c). Secondary endpoints included first‐pass effect (FPE; eTICI 2c/3 after one pass), puncture‐to‐recanalisation time, and symptomatic intracranial haemorrhage (sICH). Results Fifty‐five procedures were performed (54 LVO strokes analysed, one cerebral venous thrombosis). Median age was 69 years (IQR 58–78); 40% were female. The most common occlusion site was the intracranial ICA (56%). Median vessel diameter was 3.6 mm (IQR 2.8–4.0); median CBS 5 (IQR 4–6). Transfemoral access was used in 93%, and conscious sedation in 76%. Contact aspiration alone was the first‐line technique in 76%. The median number of passes was 2 (IQR 1–2).FPE was achieved in 37% (20/54; 95% CI, 24–51%). Final reperfusion rates were eTICI 2c/3 in 84% (46/54; 95% CI, 73–93%) and eTICI 2b/3 in 92% (50/54; 95% CI, 82–98%). Median puncture‐to‐recanalisation time was 31.5 minutes (IQR 19–56). No vessel perforation or device‐related complication occurred. Petechial haemorrhage was observed in 9% (5/54), mild subarachnoid haemorrhage in 3.4% (2/50), with reperfusion edema and sICH in one patient each (1.9%). Conclusion In this first multicentre experience, the RED‐78 catheter achieved high reperfusion rates with low complication rates, even in cases with substantial clot burden. Larger prospective studies are warranted to further assess procedural nuances and confirm clinical outcomes.