Combination Therapy for AIS

Aim for first pass success1
with a combination of compatible2 tools.​

See the power of combination therapy

When you have that power, you can combat variability and feel more confident to deliver positive procedural outcomes.1

Achieve higher rate of first-pass success.3,4

Compared to aspiration-alone and stent retriever-alone techniques, combination therapy has been shown to significantly achieve: 

  • Higher successful recanalization at first pass and at the end of the procedure
  • Shorter puncture-to-reperfusion time
  • Fewer number of passes
% first pass effect (FPE)7 (mTICI 2c-3)
Puncture-to-reperfusion time4
(median) p<0.001

Clinical evidence


A study published in 2022 evaluated the effectiveness and safety of the React™ Catheter used with a stent retriever (combined technique). 


Prospective study included 102 consecutive adult patients who underwent mechanical thrombectomy using React™ 68/71 catheter(s) with stent retriever (Solitaire™ X Revascularization device 71%* of the time) between June 2020 and July 2021.

This prospective and independent study found that the use of the React™ catheter with the Solitaire™ X device resulted in a high rate of FPE in consecutive AIS patients due to large vessel occlusion.1

Decrease procedural variability.5,6

Success of mechanical thrombectomy with a single device may be influenced by:  

  • Vessel anatomy
  • Clot composition and length
  • Angle of interaction between the aspiration catheter and clot5

With combination therapy, you can maximize procedural success by complementing the strengths of the stent retriever with the aspiration catheter to minimize the influence of a single variable.

See how combination therapy reduces procedural variability.

Decrease distal embolization3,7

Combination therapy was found to be the most efficient method for reducing the rate of clot fragmentation for hard fragment-prone clots compared to aspiration-alone and stent retriever-alone techniques.7

Aspiration-alone was found to significantly increase the risk of soft elastic clot fragmentation by twofold compared to the stent retriever-alone technique.7

Minimize the possibility of clot disruption by combining the stent retriever with the aspiration catheter.3

Facilitate smooth navigation through vascular tortuosity8

With combination therapy, you can use the stent retriever as an anchor to promote smooth navigation of the aspiration catheter to reach the occlusion site, improving reliability of tracking when positioning the aspiration catheter closer to the thrombus interface.8

Compatibility and dependability. Combined.

Trust in reliable9, compatible2 tools to combat variability.


  • The Solitaire™ X device is a clinically proven10 stent retriever with a unique overlapping parametric design that provides dynamic clot integration11 and differentiated radial outward force.12

  • The React™ Catheter is designed for trackability with the COBRA (COil + BRAid) technology8 and durability of nitinol to support the Solitaire™ X device.13

  • The Phenom™ 21/27 Catheters with 160cm length are optimized to deliver13 all sizes of the Solitaire™ X device providing smooth deliverability with a low clot-crossing profile.

The use of the React™ Catheter with the Solitaire™ X device results in high rates of FPE.1
  1. Solitaire™ X Revascularization device
  2. Phenom™ Catheter
  3. React™ Catheter
  4. Riptide™ Aspiration System
Medtronic React™ catheter, Soitaire™ X device, and Phenom™ 21/27 catheters annotated


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Figure rounded up to the nearest whole number.


Requena M, Piñana C, Olive-Gadea M, et al. Combined technique as first approach in mechanical thrombectomy: Efficacy and safety of REACT catheter combined with stent retriever [published online ahead of print, 2022 May 2]. Interv Neuroradiol. 2022;15910199221095798.


TR-NV14973B, TR-NV16168A, D00033351A, TR-NV15999B, TR-NV15399A.


Diana F, Vinci SL, Ruggiero M, et al. Comparison of aspiration versus combined technique as first-line approach in terminal internal carotid artery occlusion: A multicenter experience. J Neurointerv Surg. 2022;14(7):666–671.


Okuda T, Arimura K, Matsuo R, et al. Efficacy of combined use of a stent retriever and aspiration catheter in mechanical thrombectomy for acute ischemic stroke [published online ahead of print, 2021 Sep 20]. J Neurointerv Surg. 2021;neurintsurg-2021–017837.


Bernava G, Rosi A, Boto J, et al. Direct thromboaspiration efficacy for mechanical thrombectomy is related to the angle of interaction between the aspiration catheter and the clot. J Neurointerv Surg. 2020;12(4):396–400. 


Liu Y, Gebrezgiabhier D, Zheng Y, et al. Arterial collapse during thrombectomy for stroke: Clinical evidence and experimental findings in human brains and in vivo models. AJNR Am J Neuroradiol. 2022;43(2):251–257.


Chueh JY, Puri AS, Wakhloo AK, Gounis MJ. Risk of distal embolization with stent retriever thrombectomy and ADAPT. J Neurointerv Surg. 2016;8(2):197–202.


Li J, Tomasello A, Requena M, et al. Trackability of distal access catheters: An in vitro quantitative evaluation of navigation strategies [published online ahead of print, 2022 Apr 21]. J Neurointerv Surg. 2022;neurintsurg-2022–018889.


TR-NV15436C, D00272862C, D00344794B, TR-NV15519A, TR-NV15666A, TR-NV15346C, TR- NV14704A-1, TRNV14443A, TR-NV14704A, TR-NV15965A, D00292166B


Goyal M, Menon BK, van Zwam WH, et al. Endovascular thrombectomy after large-vessel ischaemic stroke: A meta-analysis of individual patient data from five randomised trials. Lancet. 2016;387(10029):1723–1731.


TR-NV13807A, D00419703A, TR-NV15666A, D00324045A.


D00419703A, D00324045A, TRNV12180A.


TR-NV16168A, D00033351A.