Independent Study Supports Use of Penumbra Aspiration as Frontline Thrombectomy Therapy

Penumbra Inc., a global interventional therapies company, has announced the presentation of results of the ASTER Trial, the first independent, prospective, randomized trial comparing the use of Penumbra’s aspiration system to stent retriever. The ASTER Trial provides additional evidence of Penumbra’s aspiration system as an effective frontline thrombectomy approach for acute ischemic stroke as part of the ADAPT (A Direct Aspiration, First Pass Technique) technique.
 
 “The ASTER study provides evidence that starting with Penumbra aspiration first as part of the ADAPT technique is similar to the stent retriever technique,” said Michel Piotin, M.D., principal investigator and interventional neuroradiologist at Rothschild Fondation Hospital in Paris, France. “The ADAPT technique offers the possibility to easily add a stent retriever following Penumbra aspiration if needed, leading to time savings.”
 
The data showed that the ADAPT technique compared favorably: 85.4 percent of patients treated with Penumbra’s aspiration system achieved the primary endpoint of TICI 2b/3 at the end of the procedure compared with 83.1 percent of patients treated with stent retrievers (p=0.53). Moreover, 63 percent of patients treated with Penumbra’s aspiration system achieved the secondary endpoint of TICI 2b/3 after frontline treatment compared to 67.7 percent with stent retrievers (p=0.33).
 
“The ASTER Trial shows no significant difference in revascularization rate and safety using either thrombectomy technique—Penumbra aspiration and stent retrievers—for acute ischemic stroke patients with large vessel occlusions,” said Bertrand Lapergue, M.D., Ph.D., Division of Neurology, Stroke Center, Foch Hospital, University Versailles Saint-Quentin en Yvelines (France) and scientific coordinator for the study. “The broad eligibility criteria achieved in the ASTER Trial make the results generalizable to the majority of stroke patients with large vessel occlusions.”
 
Secondary safety endpoints presented, including embolization in new territory (ENT) and symptomatic intracranial hemorrhage (sICH), were not statistically different between the two arms.
 
“The ASTER Trial builds on the results of the 3D Trial, providing additional evidence supporting the use of Penumbra System direct aspiration devices as a first-line treatment for acute ischemic stroke patients,” said Adam Elsesser, chairman, CEO and president of Penumbra. “The ADAPT technique with the Penumbra System as a frontline approach together with complementary adjunctive devices when needed offers a cost-effective solution for treating stroke patients, which is critical as patient access to mechanical thrombectomy is further expanded.”
 
The ASTER (Adapt versus StEnt Retriever) Trial is a prospective, randomized controlled study that compared the safety and efficacy of the Penumbra aspiration system used frontline as part of the ADAPT technique versus stent retrievers. The primary endpoint was end of procedure revascularization (TICI 2b/3). The study enrolled 381 patients at eight centers in France over 12 months beginning in October 2015. Penumbra provided an institutional grant to support the ASTER Trial.
 
The Penumbra System consists of large diameter, highly flexible, and reliably trackable reperfusion catheters that utilize the full aspiration power of the Penumbra Pump MAX through its Hi-Flow Aspiration Tubing. The Penumbra System enables physicians to use aspiration, which acts like a minimally invasive “vacuum” inside the artery, to remove stroke-causing blood clots from the brain safely and effectively. The Penumbra System is the only U.S. Food and Drug Administration-cleared integrated aspiration system for the revascularization of ischemic stroke patients.
 
Penumbra, headquartered in Alameda, Calif., designs, develops, manufactures, and markets neuro and peripheral vascular devices. Penumbra sells its products to hospitals primarily through its direct sales organization in the United States, most of Europe, Canada and Australia, and through distributors in select international markets.