ASTER Study Opens Door To New Tool To Remove Clot in Ischemic Stroke Interview with:
Bertrand LAPERGUE, MD, PhD
Hôpital Foch, University Versailles Saint Quentin en Yvelynes
Department of Stroke Center, Diagnostic and Interventional Neuroradiology
Suresnes, France.
Department of Diagnostic and Interventional Neuroradiology
Fondation Rothschild, Paris, France.
on behalf of the ASTER Trial Investigators. What is the background for this study? What are the main findings?

Response: Mechanical thrombectomy (MT) with a stent retriever (SR), in association with intravenous (IV) rtPA, is now the standard of care in anterior circulation ischemic stroke caused by large vessel occlusion (LVO).

Favorable outcome is strongly associated with the successful reperfusion status (TICI 2b/3= 71% with SR, Hermes Study group).
New techniques for MT such as ADAPT (A Direct first pass Aspiration Technique) seem promising to increase reperfusion status and clinical outcome in retrospective studies. What should clinicians and patients take away from your report?


  • First independent large RCT focusing on ADAPT technique with blinded assessment data.
  • ASTER trial shows no statistical difference between aspiration and stent retriever as a frontline thrombectomy approach
  • Similar efficacy and safety endpoints
  • ASTER trial opens the door to add a new tool (ADAPT) to remove the clot. What recommendations do you have for future research as a result of this study?

Response: ASTER trial opens the door to add a new tool (ADAPT) to remove the clot.
The quality of the reperfusion is a major factor of patient outcome. The rate of perfect reperfusion are arout 45% only.

Next study should assess new strategies to increase the rate of perfect reperfusion.
The Combined ASTER2 Trial (combined aspiration and stent retriever), a french large RCT across 10 stroke centers, will address this major issue. Is there anything else you would like to add?

Response: Study funded with an unrestricted research grant by Penumbra.
The study sponsor was not involved in the study design, study conduct, protocol review, or manuscript preparation and review. Thank you for your contribution to the community.


Int J Stroke. 2017 Jan 1:1747493017711948. doi: 10.1177/1747493017711948. [Epub ahead of print]

First-line use of contact aspiration for thrombectomy versus a stent retriever for recanalization in acute cerebral infarction: The randomized ASTER study protocol.

Lapergue B1, Labreuche J2, Blanc R3, Barreau X4, Berge J4, Consoli A1, Rodesch G1, Saleme S5, Costalat V6, Bracard S7, Desal H8, Duhamel A3, Baffert S3, Mazighi M3, Gory B9, Turjman F5, Piotin M3; ASTER Trial Investigators.

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on August 1, 2017 by Marie Benz MD FAAD