Multicentre AsPiration Large-vessel Evaluation: Canadian registry of RED-78 aspiration catheter (MAPLE-78)

BACKGROUND: Large-bore aspiration catheters are increasingly used for endovascular stroke treatment (EVT). The Penumbra RED-78 is a novel large-bore aspiration catheter for which no clinical data have been published to date. We aimed to assess the technical success and safety of this device. METHODS: We retrospectively collected data on consecutive patients with large-vessel occlusion acute ischemic stroke treated with the RED-78 catheter at six Canadian comprehensive stroke centres between April 2024 and December 2025. The primary endpoint was near-complete or complete reperfusion (eTICI ≥2c). Secondary endpoints included first-pass effect (FPE), puncture-to-recanalization time, and symptomatic intracranial hemorrhage (sICH). RESULTS: Sixty patients underwent EVT with the RED-78 catheter. Median age was 71 years (IQR 59-78), and 22 (36.7%) were female. The intracranial ICA was the most frequent occlusion site (36/60, 60%). Median vessel diameter at the occlusion site was 3.8 mm (IQR 3.5-4.4), and median clot burden score was 5 (IQR 4-6). Contact aspiration alone was the frontline technique in 47/60 (78.3%). The median number of passes was 2 (IQR 1-2). FPE was achieved in 21/60 patients (35.0%). Final eTICI 2c/3 reperfusion was achieved in 53/60 (88.3%). Median puncture-to-recanalization time was 30 minutes (IQR 20-49). No vessel perforations or device-related complications occurred. sICH was observed in 1/60 patients (1.7%). CONCLUSIONS: In this multicentre experience, the RED-78 catheter achieved high reperfusion rates with a favorable safety profile. These findings support its use as an effective large-bore aspiration device.