Key result
SOFIA catheter achieves ~90% successful recanalization in acute ischemic stroke using ADAPT or Solumbra.
Why the study?
The safety and efficacy of the recently FDA-approved SOFIA aspiration catheter for mechanical thrombectomy in acute ischemic stroke via ADAPT and Solumbra techniques required systematic evaluation.
Meta-Analysis (n=1,836)
Absolute Event Rate: 89.3% vs 93%
Supports SOFIA use in AIS thrombectomy regardless of technique; extends observational data but prospective RCTs needed before practice change.
INTRODUCTION: SOFIA catheter is a relatively new and recently FDA-approved aspiration catheter. This systematic review aims to investigate the safety and efficacy of SOFIA catheter for treatment of acute ischemic stroke (AIS) via ADAPT and Solumbra techniques. METHODS: Search of all studies evaluating the SOFIA catheter for mechanical thrombectomy (MT) for treatment of AIS via ADAPT and Solumbra techniques from inception through 2020 on Pubmed, PMC, and Embase was performed. We analyzed the angiographic and clinical outcomes of both techniques with SOFIA catheter using the random-effects model. RESULTS: From 18 studies, 1836 patients were included with 1365 receiving MT using ADAPT and 471 with solumbra technique. The mean age was 69.8 years and 51.1% of the patients were women. The rate of rescue therapy was 30%. The outcomes rates of ADAPT group were as follows; mFPE (59.3%), FPE (34.4%) final TICI 2b/3 (89.3%), procedural complications (8%), embolization to new territory (ENT) (2.3%), symptomatic ICH (5.4%), mean NIHSS (8.97), 90-day-mRS 0-2 (48.8%), and mortality (15.3%). The outcomes rates of Solumbra group were as follows; mFPE (60.5%), FPE (46.7%), final TICI 2b/3 (93%), procedural complications (6.4%), ENT (2%), symptomatic ICH (6%), mean NIHSS (7.59), mRS 0-2 (53.8%), and mortality (10.8%). ICA and posterior circulation strokes, and tandem lesions had worse outcomes (P < .005). MCA strokes were associated with better outcomes (P = .005). ASPECT scores' association with the clinical outcomes was found statistically significant. CONCLUSION: SOFIA catheter is effective and safe to treat acute ischemic stroke regardless of applied MT technique.
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Essibayi et al. (2022) conducted a meta-analysis in acute ischemic stroke (n=1,836). SOFIA aspiration catheter via ADAPT technique vs. Solumbra technique was evaluated on final TICI 2b/3. Mechanical thrombectomy using the SOFIA aspiration catheter achieved high rates of final TICI 2b/3 (89.3% for ADAPT vs 93% for Solumbra) and 90-day mRS 0-2 (48.8% vs 53.8%) in acute ischemic stroke.
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