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Background and purposeAspiration thrombectomy of large vessel occlusions has made a comeback among recanalization techniques thanks to recent advances in catheter technology resulting in faster recanalization and promising clinical results when used either alone or as an adjunct to stent retriever. This multicenter retrospective study reports angiographic data, complications, and clinical outcome in patients treated with aspiration thrombectomy as the first-line option.Materials and methodsWe analysed the clinical and procedural data of patients treated from January 2014 to March 2015. Recanalization was assessed according to the Thrombolysis in Cerebral Infarction score. Clinical outcome was evaluated at discharge and after 3 months.ResultsOverall, 152 patients (mean age 68 years) were treated. Sites of occlusion were 90.8% anterior circulation (including 16.4% tandem extracranial/intracranial occlusions) and 9.2% basilar artery. In 79 patients administration of intravenous tissue plasminogen activator was attempted. Recanalization of the target vessel was obtained in 115/152 cases (75.6%) whereas direct aspiration alone was successful in 83/152 cases (54.6%) with an average puncture to revascularization time of 44.67 min. Symptomatic intracranial hemorrhage occurred in 7.8% and embolization to new territories in 1.9%. 77 patients (50.6%) had a good outcome at 90-day follow-up: 55/96 in the direct aspiration alone group and 22/56 in the aspiration-stent retriever group.ConclusionsDirect aspiration thrombectomy appears a feasible technique with good revascularization results achieved in more than half the patients. In light of the self-reported data, inhomogeneous patient selection, absence of a core imaging laboratory, and a non-standardized approach, the results should be validated in a larger trial.

Recently, this journal published a paper from Marr et al 1 concerning multi-drug intra-arterial chemotherapy (IAC) for intraocular retinoblastoma. In many centres IAC has quickly garnered exciting interest, emerging as a promising, highly effective alternative for globe conserving treatment.2–4 In our institution, IAC with melphalan (IACM) has been performed since June 2008, and topotecan was added in June 2011. Fifty-nine patients have at least 1 year follow-up. Here we report our results obtained with IACM. Forty-seven patients (table 1) for a total of 52 eyes with 22 newly diagnosed intraocular retinoblastomas (ND-RTBs) and 30 intraocular retinoblastomas after partial remission and/or relapses after other therapies (PR/R-RTBs) underwent IACM after a multidisciplinary group approval.5 The range of follow-up time is 19–61 months (median 39.6 months). View this table: Table 1 Demographics, previous therapies, modalities of intra-arterial chemotherapy with melphalan (IACM), associated therapies, and follow-up of 47 patients* with 52 eyes with intraocular retinoblastoma (RTB) Two …