Abstract Number: Esoc2026a1900 Neva Stent Retriever in Mechanical Thrombectomy: First-Pass Reperfusion, Device Switching and Reperfusion Rates in a Single-Centre Retrospective Study

Abstract Background and aims Mechanical Thrombectomy (MT) is part of the standard treatment for acute ischemic stroke due to large vessel occlusion. NeVa stent retrievers were designed to improve first-pass reperfusion and have been available since December 2021. This study compares first-pass reperfusion, device switching, and final reperfusion rates of NeVa with other thrombectomy strategies. Methods All patients treated with MT between December 2021-2023 were included. Cases were excluded if documentation was incomplete or if initial occlusion was too distal. Analyses were purely descriptive; first-line strategy was defined as the initially applied approach, including NeVa with or without aspiration, aspiration alone, or other stent retriever with or without aspiration. Device choice was at the operator´s discretion. Successful reperfusion was defined as mTICI ≥ 2b. Results A total of 243 patients were included, median age was 73.2 years and NIHSS score was 14 (IQR 9). First-pass reperfusion was achieved in 60.32% when NeVa was used, compared to 46.11% with non-NeVa strategies. Switching to NeVa after a first aspiration attempt occurred in four cases, with 75% success. Switching from aspiration to other stent retrievers occurred in 12 cases, with a first-pass success rate of 33.33%. Final reperfusion rate was 95.24% in the NeVa first-line group and 88.33% in the non-NeVa first-line group. Conclusions In this study, NeVa use as a first-line stent retriever was associated with higher first-pass and final reperfusion rates compared to other first-line strategies. Early switching from aspiration to NeVa showed favourable descriptive outcomes. These findings should be interpreted considering the retrospective, single-centre design. Conflict of interest Katharina Haider position funding: RFA-Research funding for appointed full professors of Paracelsus Medical University (PMU), Salzburg Austria (RFA-24-05-Pfaff), other than this nothing to disclose