Abstract Number ‐ 25: Acute Ischemic Stroke Intervention With Penumbra RED Reperfusion Catheters: Updated Subset Analysis From INSIGHT Registry

Introduction The prospective INSIGHT Registry is a multicenter ‘multi‐omic’ analysis of thrombi associated with acute hemorrhagic or ischemic stroke. This updated interim analysis evaluated the performance of Penumbra RED catheters used during aspiration thrombectomy for acute ischemic stroke (AIS). Methods All AIS cases in which Penumbra RED aspiration catheters (RED 62, 68, or 72) were utilized as a frontline treatment were included in the analysis. Retrieved clot fragments were classified based on their gross appearance. Key time metrics and procedural data were also collected, including first‐pass / post‐procedure modified Treatment in Cerebral Ischemia (mTICI) score. Results Of 400 patients enrolled across 25 US centers, 161 underwent thrombectomy with Penumbra RED catheters over ten months (Jul 2021 through Apr 2022). The mean patient age was 70.7 years, and 50.9% were female. The middle cerebral artery first segment (M1) was the most common primary occlusion site (60.4%; 96/159). IV t‐PA was administered before the procedure in 13.7% (22/161) of patients. The median time from stroke onset / last known well to mTICI≥ 2b was 5.0 hrs. [IQR 3‐11], and the median time from a puncture to mTICI≥ 2b was 23.0 mins [IQR 15‐31]. Firm‐red clots represented 45.3% (67/148), while soft‐red clots were found in 37.8% (56/148) of retrieved clots. In turn, firm‐white and soft‐white clots were seen in 11.5% (17/148) and 5.4% (8/148) of cases, respectively. Rates of the first pass and final mTICI≥ 2b scores by clot type are shown in Table 1. Conclusions Aspiration thrombectomy with Penumbra RED catheters resulted in good revascularization rates for all clot types.