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采用互锁笼的取栓支架(ERIC)与传统支架取栓器治疗血栓切除术的比较:基于倾向评分的分析。

Embolus Retriever with Interlinked Cages (ERIC) versus conventional stent retrievers for thrombectomy: a propensity score-based analysis.

机构信息

Interventional Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.

Neuroradiology, Centre Hospitalier Universitaire de Nantes, Nantes, Pays de la Loire, France.

出版信息

J Neurointerv Surg. 2021 Mar;13(3):255-260. doi: 10.1136/neurintsurg-2020-016289. Epub 2020 Jun 30.

Abstract

BACKGROUND

The Embolus Retriever with Interlinked Cages (ERIC) is one of the latest devices for thrombectomies. It has several architectural features that are supposed to enhance its ability to remove clots and prevent distal emboli. We aimed to compare ERIC with standard stent retrievers (SRs) using propensity score (PS) matching.

METHODS

The clinical and radiological data of all consecutive patients treated with ERIC or standard FDA-approved stent retrievers were collected from a prospective multicenter registry. We compared procedural outcomes (recanalization rates according to the modified Thrombolysis In Cerebral Infarction (mTICI) score and procedural complications) and clinical outcomes (modified Rankin Scale (mRS) and mortality at 3 months). Matching of the populations with PS was performed to account for differences in baseline characteristics.

RESULTS

A total of 1230 patients were included. In both the PS-matched cohort (195 ERIC patients, 630 SR patients) and the inverse probability of treatment weighting PS-adjusted cohort (206 ERIC patients, 1024 SR patients) there was no difference in terms of successful recanalization (modified TICI score ≥2b), good clinical outcome (mRS=0-2 or equal to pre-stroke mRS), or mortality at 3 months. Patients treated with first-line ERIC had a higher rate of complete recanalization (mTICI 3); however, they also required more passes and more frequent rescue therapy than the SR patient group.

CONCLUSION

In a large multicenter registry with PS matching, the ERIC device provided equivalent angiographic and clinical results to conventional SRs.

CLINICAL TRIAL REGISTRATION

URL: http://www.clinicaltrials.gov Unique identifier: NCT03776877.

摘要

背景

Embolus Retriever with Interlinked Cages(ERIC)是最新的血栓切除术器械之一。它具有几种结构特征,旨在增强其清除血栓和防止远端栓塞的能力。我们旨在使用倾向评分(PS)匹配来比较 ERIC 与标准支架取栓器(SR)。

方法

从一个前瞻性多中心登记处收集所有连续接受 ERIC 或标准 FDA 批准的支架取栓器治疗的患者的临床和影像学数据。我们比较了手术结果(根据改良脑梗死溶栓(mTICI)评分的再通率和手术并发症)和临床结果(改良 Rankin 量表(mRS)和 3 个月时的死亡率)。使用 PS 进行人群匹配,以弥补基线特征的差异。

结果

共纳入 1230 例患者。在 PS 匹配队列(195 例 ERIC 患者,630 例 SR 患者)和逆概率治疗加权 PS 调整队列(206 例 ERIC 患者,1024 例 SR 患者)中,再通率(改良 TICI 评分≥2b)、良好的临床结果(mRS=0-2 或等于卒中前 mRS)和 3 个月死亡率均无差异。一线治疗采用 ERIC 的患者完全再通率(mTICI 3)较高;然而,与 SR 患者组相比,他们需要更多的通过次数和更频繁的挽救治疗。

结论

在一项具有 PS 匹配的大型多中心登记研究中,ERIC 装置与常规 SR 相比提供了等效的血管造影和临床结果。

临床试验注册

网址:http://www.clinicaltrials.gov 唯一标识符:NCT03776877。

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