Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke Primary Results of the STRATIS Registry

被引：159

作者：

Mueller-Kronast, Nils H. ^{[1
]}

Zaidat, Osama O. ^{[2
]}

Froehler, Michael T. ^{[3
]}

Jahan, Reza ^{[4
]}

Aziz-Sultan, Mohammad Ali ^{[5
]}

Klucznik, Richard P. ^{[6
]}

Saver, Jeffrey L. ^{[4
]}

Hellinger, Frank R., Jr. ^{[7
]}

Yavagal, Dileep R. ^{[8
]}

Yao, Tom L. ^{[9
]}

Liebeskind, David S.

Jadhav, Ashutosh P. ^{[10
]}

Gupta, Rishi ^{[11
]}

Hassan, Ameer E. ^{[12
]}

Martin, Coleman O. ^{[13
]}

Bozorgchami, Hormozd ^{[14
]}

Kaushal, Ritesh ^{[1
]}

Nogueira, Raul G. ^{[15
]}

Gandhi, Ravi H. ^{[7
]}

Peterson, Eric C. ^{[8
]}

Dashti, Shervin R. ^{[9
]}

Given, Curtis A., II ^{[16
]}

Mehta, Brijesh P. ^{[17
]}

Deshmukh, Vivek ^{[18
]}

Starkman, Sidney ^{[4
]}

Linfante, Italo ^{[19
]}

McPherson, Scott H. ^{[20
]}

Kvamme, Peter ^{[21
]}

Grobelny, Thomas J. ^{[22
]}

Hussain, Muhammad S. ^{[23
]}

Thacker, Ike ^{[24
]}

Vora, Nirav ^{[25
]}

Chen, Peng Roc ^{[26
]}

Monteith, Stephen J. ^{[27
]}

Ecker, Robert D. ^{[28
]}

Schirmer, Clemens M. ^{[29
]}

Sauvageau, Eric ^{[30
]}

Abou-Chebl, Alex ^{[31
]}

Derdeyn, Colin P. ^{[32
]}

Maidan, Lucian ^{[33
]}

Badruddin, Aamir ^{[34
]}

Siddiqui, Adnan H. ^{[35
]}

Dumont, Travis M. ^{[36
]}

Alhajeri, Abdulnasser ^{[37
]}

Taqi, M. Asif ^{[38
]}

Asi, Khaled ^{[39
]}

Carpenter, Jeffrey ^{[40
]}

Boulos, Alan ^{[41
]}

Jindal, Gaurav ^{[42
]}

Puri, Ajit S. ^{[43
]}

机构：

[1] Adv Neurosci Network Tenet South Florida, 5352 Linton Blvd, Delray Beach, FL 33484 USA

[2] St Vincent Mercy Hosp, Toledo, OH USA

[3] Vanderbilt Univ, Med Ctr, Nashville, TN USA

[4] Univ Calif Los Angeles, Los Angeles, CA 90024 USA

[5] Brigham & Womens Hosp, 75 Francis St, Boston, MA 02115 USA

[6] Methodist Hosp, 6535 Fannin, Houston, TX 77030 USA

[7] Florida Hosp Neurosci Inst, Winter Pk, FL USA

[8] Univ Miami, Jackson Mem Hosp, Miller Sch Med, Coral Gables, FL 33124 USA

[9] Norton Neurosci Inst, Norton Healthcare, Louisville, KY USA

[10] Univ Pittsburgh, Med Ctr, Pittsburgh, PA 15260 USA

[11] WellStar Kennestone Reg Med Ctr, WellStar Neurosci Network, Marietta, GA USA

[12] Valley Baptist Med Ctr, Harlingen, TX USA

[13] St Lukes Hosp, Kansas City, MO USA

[14] Oregon Hlth & Sci Univ Hosp, Portland, OR USA

[15] Emory Univ, Grady Mem Hosp, Sch Med, Atlanta, GA USA

[16] Baptist Hlth Lexington, Cent Baptist, Lexington, KY USA

[17] South Broward Hosp, Hollywood, FL USA

[18] Providence St Vincent Med Ctr, Portland, OR USA

[19] Baptist Hosp Miami, Miami, FL USA

[20] St Dominics Jackson Mem Hosp, Jackson, MS USA

[21] Univ Tennessee, Med Ctr, Knoxville, TN USA

[22] Advocate Christ Med Ctr, Oak Lawn, IL USA

[23] Cleveland Clin, Cleveland, OH 44106 USA

[24] Baylor Univ, Med Ctr, Dallas, TX USA

[25] OhioHealth Riverside Methodist Hosp, Columbus, OH USA

[26] Mem Hermann Texas Med Ctr, Houston, TX USA

[27] Swedish Med Ctr, First Hill Campus, Seattle, WA USA

[28] Maine Med Ctr, Portland, ME 04102 USA

[29] Geisinger Med Clin, Danville, PA USA

[30] Baptist Med Center Jacksonville, Jacksonville, FL USA

[31] Baptist Hosp Louisville, Louisville, KY USA

[32] Barnes Jewish Hosp, St Louis, MO 63110 USA

[33] Mercy San Juan Med Ctr & Mercy Gen, Carmichael, CA USA

[34] Presence St Joseph Med Ctr, Joliet, IL USA

[35] Buffalo Gen Med Ctr, Buffalo, NY USA

[36] Univ Arizona, Med Ctr, Tucson, AZ USA

[37] Univ Kentucky Hosp, Lexington, KY USA

[38] Robles Med Ctr, Thousand Oaks, CA USA

[39] Aurora Hosp, Milwaukee, WI USA

[40] Univ Virginia, Ruby Mem Hosp, Morgantown, WV USA

[41] Albany Med Ctr, Albany, NY USA

[42] Univ Maryland, Med Ctr, Baltimore, MD 21201 USA

[43] Univ Massachusetts, Mem Med Ctr, Worcester, MA 01605 USA

[44] Crouse Hosp, Syracuse, NY USA

[45] Virginia Mason Med Ctr, Seattle, WA 98101 USA

[46] Mayo Clin, Rochester, MN USA

[47] Erlanger Med Ctr, Chattanooga, TN USA

[48] ProMed Toledo Hosp, Toledo, OH USA

[49] Banner Univ, Med Ctr, Phoenix, AZ USA

[50] McLaren Flint, Flint, MI USA

来源：

STROKE | 2017年 / 48卷 / 10期

关键词：

ischemic stroke; Mindframe Capture; registry; Solitaire; stent; system of care; thrombectomy; ENDOVASCULAR THERAPY; CONSENSUS STATEMENT; THROMBECTOMY; GUIDELINES; OUTCOMES; OCCLUSION; UPDATE; TRENDS; BYPASS; VOLUME;

D O I：

10.1161/STROKEAHA.117.016456

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background and Purpose-Mechanical thrombectomy with stent retrievers has become standard of care for treatment of acute ischemic stroke patients because of large vessel occlusion. The STRATIS registry (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke) aimed to assess whether similar process timelines, technical, and functional outcomes could be achieved in a large real world cohort as in the randomized trials. Methods-STRATIS was designed to prospectively enroll patients treated in the United States with a Solitaire Revascularization Device and Mindframe Capture Low Profile Revascularization Device within 8 hours from symptom onset. The STRATIS cohort was compared with the interventional cohort of a previously published SEER patient-level meta-analysis. Results-A total of 984 patients treated at 55 sites were analyzed. The mean National Institutes of Health Stroke Scale score was 17.3. Intravenous tissue-type plasminogen activator was administered in 64.0%. The median time from onset to arrival in the enrolling hospital, door to puncture, and puncture to reperfusion were 138, 72, and 36 minutes, respectively. The Core lab-adjudicated modified Thrombolysis in Cerebral Infarction >= 2b was achieved in 87.9% of patients. At 90 days, 56.5% achieved a modified Rankin Scale score of 0 to 2, all-cause mortality was 14.4%, and 1.4% suffered a symptomatic intracranial hemorrhage. The median time from emergency medical services scene arrival to puncture was 152 minutes, and each hour delay in this interval was associated with a 5.5% absolute decline in the likelihood of achieving modified Rankin Scale score 0 to 2. Conclusions-This largest-to-date Solitaire registry documents that the results of the randomized trials can be reproduced in the community. The decrease of clinical benefit over time warrants optimization of the system of care.

引用

页码：2760 / +

页数：32

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