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

Osama O. Zaidat, Alicia C. Castonguay, Raul G. Nogueira, Diogo C. Haussen, Joey D. English, Sudhakar R. Satti, Jennifer Chen, Hamed Farid, Candace Borders, Erol Veznedaroglu, Mandy J. Binning, Ajit Puri, Nirav A. Vora, Ron F. Budzik, Guilherme Dabus, Italo Linfante, Vallabh Janardhan, Amer Alshekhlee, Michael G. Abraham, Randall Edgell & 10 others Muhammad Asif Taqi, Ramy El Khoury, Maxim Mokin, Aniel Q. Majjhoo, Mouhammed R. Kabbani, Michael T. Froehler, Ira Finch, Sameer A. Ansari, Roberta Novakovic, Thanh N. Nguyen

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background: Recent 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 (TRAC K) multicenter Registry aimed to evaluate the use of the Trevo device in everyday clinical practice. Methods: Twenty-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). Results: A total of 634patients were included. Mean age was 66.1±14.8 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±264.5 min and 78.8±49.6 min, 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 6 hours (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. Conclusion: The TRAC K 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.

Original languageEnglish (US)
Pages (from-to)516-524
Number of pages9
JournalJournal of NeuroInterventional Surgery
Volume10
Issue number6
DOIs
StatePublished - Jun 1 2018

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Thrombectomy
Stents
Registries
Stroke
Intracranial Hemorrhages
Cerebral Infarction
Randomized Controlled Trials
Guidelines
Equipment and Supplies
Mortality
Punctures
Catheters

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Zaidat, O. O., Castonguay, A. C., Nogueira, R. G., Haussen, D. C., English, J. D., Satti, S. R., ... Nguyen, T. N. (2018). TREVO stent-retriever mechanical thrombectomy for acute ischemic stroke secondary to large vessel occlusion registry. Journal of NeuroInterventional Surgery, 10(6), 516-524. https://doi.org/10.1136/neurintsurg-2017-013328

TREVO stent-retriever mechanical thrombectomy for acute ischemic stroke secondary to large vessel occlusion registry. / Zaidat, Osama O.; Castonguay, Alicia C.; Nogueira, Raul G.; Haussen, Diogo C.; English, Joey D.; Satti, Sudhakar R.; Chen, Jennifer; Farid, Hamed; Borders, Candace; Veznedaroglu, Erol; Binning, Mandy J.; Puri, Ajit; Vora, Nirav A.; Budzik, Ron F.; Dabus, Guilherme; Linfante, Italo; Janardhan, Vallabh; Alshekhlee, Amer; Abraham, Michael G.; Edgell, Randall; Taqi, Muhammad Asif; El Khoury, Ramy; Mokin, Maxim; Majjhoo, Aniel Q.; Kabbani, Mouhammed R.; Froehler, Michael T.; Finch, Ira; Ansari, Sameer A.; Novakovic, Roberta; Nguyen, Thanh N.

In: Journal of NeuroInterventional Surgery, Vol. 10, No. 6, 01.06.2018, p. 516-524.

Research output: Contribution to journalArticle

Zaidat, OO, Castonguay, AC, Nogueira, RG, Haussen, DC, English, JD, Satti, SR, Chen, J, Farid, H, Borders, C, Veznedaroglu, E, Binning, MJ, Puri, A, Vora, NA, Budzik, RF, Dabus, G, Linfante, I, Janardhan, V, Alshekhlee, A, Abraham, MG, Edgell, R, Taqi, MA, El Khoury, R, Mokin, M, Majjhoo, AQ, Kabbani, MR, Froehler, MT, Finch, I, Ansari, SA, Novakovic, R & Nguyen, TN 2018, 'TREVO stent-retriever mechanical thrombectomy for acute ischemic stroke secondary to large vessel occlusion registry', Journal of NeuroInterventional Surgery, vol. 10, no. 6, pp. 516-524. https://doi.org/10.1136/neurintsurg-2017-013328
Zaidat, Osama O. ; Castonguay, Alicia C. ; Nogueira, Raul G. ; Haussen, Diogo C. ; English, Joey D. ; Satti, Sudhakar R. ; Chen, Jennifer ; Farid, Hamed ; Borders, Candace ; Veznedaroglu, Erol ; Binning, Mandy J. ; Puri, Ajit ; Vora, Nirav A. ; Budzik, Ron F. ; Dabus, Guilherme ; Linfante, Italo ; Janardhan, Vallabh ; Alshekhlee, Amer ; Abraham, Michael G. ; Edgell, Randall ; Taqi, Muhammad Asif ; El Khoury, Ramy ; Mokin, Maxim ; Majjhoo, Aniel Q. ; Kabbani, Mouhammed R. ; Froehler, Michael T. ; Finch, Ira ; Ansari, Sameer A. ; Novakovic, Roberta ; Nguyen, Thanh N. / TREVO stent-retriever mechanical thrombectomy for acute ischemic stroke secondary to large vessel occlusion registry. In: Journal of NeuroInterventional Surgery. 2018 ; Vol. 10, No. 6. pp. 516-524.
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title = "TREVO stent-retriever mechanical thrombectomy for acute ischemic stroke secondary to large vessel occlusion registry",
abstract = "Background: Recent 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 (TRAC K) multicenter Registry aimed to evaluate the use of the Trevo device in everyday clinical practice. Methods: Twenty-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). Results: A total of 634patients were included. Mean age was 66.1±14.8 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±264.5 min and 78.8±49.6 min, 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 6 hours (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. Conclusion: The TRAC K 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.",
author = "Zaidat, {Osama O.} and Castonguay, {Alicia C.} and Nogueira, {Raul G.} and Haussen, {Diogo C.} and English, {Joey D.} and Satti, {Sudhakar R.} and Jennifer Chen and Hamed Farid and Candace Borders and Erol Veznedaroglu and Binning, {Mandy J.} and Ajit Puri and Vora, {Nirav A.} and Budzik, {Ron F.} and Guilherme Dabus and Italo Linfante and Vallabh Janardhan and Amer Alshekhlee and Abraham, {Michael G.} and Randall Edgell and Taqi, {Muhammad Asif} and {El Khoury}, Ramy and Maxim Mokin and Majjhoo, {Aniel Q.} and Kabbani, {Mouhammed R.} and Froehler, {Michael T.} and Ira Finch and Ansari, {Sameer A.} and Roberta Novakovic and Nguyen, {Thanh N.}",
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TY - JOUR

T1 - TREVO stent-retriever mechanical thrombectomy for acute ischemic stroke secondary to large vessel occlusion registry

AU - Zaidat, Osama O.

AU - Castonguay, Alicia C.

AU - Nogueira, Raul G.

AU - Haussen, Diogo C.

AU - English, Joey D.

AU - Satti, Sudhakar R.

AU - Chen, Jennifer

AU - Farid, Hamed

AU - Borders, Candace

AU - Veznedaroglu, Erol

AU - Binning, Mandy J.

AU - Puri, Ajit

AU - Vora, Nirav A.

AU - Budzik, Ron F.

AU - Dabus, Guilherme

AU - Linfante, Italo

AU - Janardhan, Vallabh

AU - Alshekhlee, Amer

AU - Abraham, Michael G.

AU - Edgell, Randall

AU - Taqi, Muhammad Asif

AU - El Khoury, Ramy

AU - Mokin, Maxim

AU - Majjhoo, Aniel Q.

AU - Kabbani, Mouhammed R.

AU - Froehler, Michael T.

AU - Finch, Ira

AU - Ansari, Sameer A.

AU - Novakovic, Roberta

AU - Nguyen, Thanh N.

PY - 2018/6/1

Y1 - 2018/6/1

N2 - Background: Recent 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 (TRAC K) multicenter Registry aimed to evaluate the use of the Trevo device in everyday clinical practice. Methods: Twenty-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). Results: A total of 634patients were included. Mean age was 66.1±14.8 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±264.5 min and 78.8±49.6 min, 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 6 hours (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. Conclusion: The TRAC K 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.

AB - Background: Recent 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 (TRAC K) multicenter Registry aimed to evaluate the use of the Trevo device in everyday clinical practice. Methods: Twenty-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). Results: A total of 634patients were included. Mean age was 66.1±14.8 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±264.5 min and 78.8±49.6 min, 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 6 hours (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. Conclusion: The TRAC K 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.

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U2 - 10.1136/neurintsurg-2017-013328

DO - 10.1136/neurintsurg-2017-013328

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SP - 516

EP - 524

JO - Journal of NeuroInterventional Surgery

JF - Journal of NeuroInterventional Surgery

SN - 1759-8478

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