TREVO stent-retriever mechanical thrombectomy for acute ischemic stroke secondary to large vessel occlusion registry

被引：116

作者：

Zaidat, Osama O. ^{[1
,2
,3
]}

Castonguay, Alicia C. ^{[4
]}

Nogueira, Raul G. ^{[5
]}

Haussen, Diogo C. ^{[5
]}

English, Joey D. ^{[6
]}

Satti, Sudhakar R. ^{[7
]}

Chen, Jennifer ^{[8
]}

Farid, Hamed ^{[9
]}

Borders, Candace ^{[10
]}

Veznedaroglu, Erol ^{[11
]}

Binning, Mandy J. ^{[11
]}

Puri, Ajit ^{[12
]}

Vora, Nirav A. ^{[13
]}

Budzik, Ron F. ^{[13
]}

Dabus, Guilherme ^{[14
]}

Linfante, Italo ^{[14
]}

Janardhan, Vallabh ^{[15
]}

Alshekhlee, Amer ^{[16
]}

Abraham, Michael G. ^{[17
,18
]}

Edgell, Randall ^{[19
]}

Taqi, Muhammad Asif ^{[20
]}

El Khoury, Ramy ^{[21
]}

Mokin, Maxim ^{[22
]}

Majjhoo, Aniel Q. ^{[23
]}

Kabbani, Mouhammed R. ^{[24
]}

Froehler, Michael T. ^{[25
,26
,27
]}

Finch, Ira ^{[28
]}

Ansari, Sameer A. ^{[29
,30
,31
]}

Novakovic, Roberta ^{[32
,33
,34
]}

Nguyen, Thanh N. ^{[35
]}

机构：

[1] St Vincent Mercy Med Ctr, Dept Endovasc Neurosurg, Toledo, OH USA

[2] St Vincent Mercy Med Ctr, Dept Stroke, Toledo, OH USA

[3] Mercy Hlth St Vincent Hosp, Neurosci & Stroke Ctr, Toledo, OH USA

[4] Univ Texas Houston, Dept Biostat, Houston, TX USA

[5] Emory Univ, Sch Med, Dept Neurol, Atlanta, GA 30322 USA

[6] Calif Pacific Med Ctr, Atlanta, FL USA

[7] Christiana Care Hlth Syst, Dept Neurointervent Surg, Newark, DE USA

[8] Sidney Kimmel Med Coll, Philadelphia, PA USA

[9] St Jude Med Ctr, Dept Neurointervent Radiol, Fullerton, CA USA

[10] Univ Calif Irvine, Sch Med, Irvine, CA 92717 USA

[11] Drexel Neurosci Inst, Dept Neurosurg, Philadelphia, PA USA

[12] Univ Massachusetts, Sch Med, Dept Radiol, Worcester, MA USA

[13] Riverside Radiol & Intervent Associates, Dept Radiol, Columbus, OH USA

[14] Baptist Cardiac & Vasc Inst, Dept Neurointervent Surg, Miami, FL USA

[15] Texas Stroke Inst, Plano, TX USA

[16] St Louis Univ, SSM Neurosci Inst, DePaul Stroke Ctr, Dept Vasc & Intervent Neurol, St Louis, MO 63103 USA

[17] Univ Kansas, Med Ctr, Dept Neurol, Lawrence, KS 66045 USA

[18] Univ Kansas, Med Ctr, Dept Intervent Radiol, Lawrence, KS 66045 USA

[19] St Louis Univ, Dept Neurol, St Louis, MO 63103 USA

[20] Los Robles Hosp & Med Ctr, Dept Neurol & Neurosurg, Thousand Oaks, CA USA

[21] Tulane Univ, Dept Neurol, New Orleans, LA 70118 USA

[22] Univ S Florida, Dept Neurosurg & Brain Repair, Tampa, FL USA

[23] Wayne State Sch Med, Dept Neurol, Detroit, MI USA

[24] Gundersen Hlth Syst, Dept Neurosurg, La Crosse, WI USA

[25] Vanderbilt Univ, Med Ctr, Dept Neurol, Nashville, TN USA

[26] Vanderbilt Univ, Med Ctr, Dept Neurosurg, Nashville, TN USA

[27] Vanderbilt Univ, Med Ctr, Dept Radiol, Nashville, TN 37232 USA

[28] John Muir Hlth, Walnut Creek, CA USA

[29] Northwestern Univ, Feinberg Sch Med, Dept Radiol, Chicago, IL 60611 USA

[30] Northwestern Univ, Feinberg Sch Med, Dept Neurol, Chicago, IL 60611 USA

[31] Northwestern Univ, Feinberg Sch Med, Dept Neurol Surg, Chicago, IL 60611 USA

[32] UT Southwestern Med Ctr, Dept Radiol, Dallas, TX USA

[33] UT Southwestern Med Ctr, Dept Neurol, Dallas, TX USA

[34] UT Southwestern Med Ctr, Dept Neurotherapeut, Dallas, TX USA

[35] Boston Med Ctr, Dept Neurol Neurosurg & Radiol, Boston, MA USA

来源：

JOURNAL OF NEUROINTERVENTIONAL SURGERY | 2018年 / 10卷 / 06期

关键词：

stroke; stent-retriever; trevo; mechanical; thrombectomy; revascularization; INDIVIDUAL PATIENT DATA; ENDOVASCULAR THROMBECTOMY; RANDOMIZED-TRIALS; REVASCULARIZATION; METAANALYSIS; RECOMMENDATIONS; STANDARDS; OUTCOMES; DEVICE; CARE;

D O I：

10.1136/neurintsurg-2017-013328

中图分类号：

R445 [影像诊断学];

学科分类号：

100207 ;

摘要：

BackgroundRecent randomized clinical trials (RCTs) demonstrated the efficacy of mechanical thrombectomy using stent-retrievers in patients with acute ischemic stroke (AIS) with large vessel occlusions; however, it remains unclear if these results translate to a real-world setting. The TREVO Stent-Retriever Acute Stroke (TRACK) multicenter Registry aimed to evaluate the use of the Trevo device in everyday clinical practice.MethodsTwenty-three centers enrolled consecutive AIS patients treated from March 2013 through August 2015 with the Trevo device. The primary outcome was defined as achieving a Thrombolysis in Cerebral Infarction (TICI) score of 2b. Secondary outcomes included 90-day modified Rankin Scale (mRS), mortality, and symptomatic intracranial hemorrhage (sICH).ResultsA total of 634patients were included. Mean age was 66.114.8 years and mean baseline NIH Stroke Scale (NIHSS) score was 17.4 +/- 6.7; 86.7% had an anterior circulation occlusion. Mean time from symptom onset to puncture and time to revascularization were 363.1 +/- 264.5min and 78.8 +/- 49.6min, respectively. 80.3% achieved TICI 2b. 90-day mRS 2 was achieved in 47.9%, compared with 51.4% when restricting the analysis to the anterior circulation and within 6hours (similar to recent AHA/ASA guidelines), and 54.3% for those who achieved complete revascularization. The 90-day mortality rate was 19.8%. Independent predictors of clinical outcome included age, baseline NIHSS, use of balloon guide catheter, revascularization, and sICH.ConclusionThe TRACK Registry results demonstrate the generalizability of the recent thrombectomy RCTs in real-world clinical practice. No differences in clinical and angiographic outcomes were shown between patients treated within the AHA/ASA guidelines and those treated outside the recommendations.

引用

页码：516 / 524

页数：9

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