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新型支架取栓器 Tron FX 治疗近端和远端颅内大血管闭塞的临床试验。

Clinical Trial of the New Stent Retriever Tron FX for both Proximal and Distal Intracranial Large Vessel Occlusions.

机构信息

Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan.

Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan; Center for Clinical Research and Innovation, Kobe City Medical Center General Hospital, Kobe, Japan.

出版信息

J Stroke Cerebrovasc Dis. 2021 Mar;30(3):105585. doi: 10.1016/j.jstrokecerebrovasdis.2020.105585. Epub 2021 Jan 5.

Abstract

BACKGROUND

In all of randomized controlled trials of mechanical thrombectomy, the target vessels were proximal. Herein we report a clinical trial of the Tron FX stent retriever, including the smallest size of 2/15 mm for distal intracranial large vessel occlusion (LVO).

OBJECTIVE

Eligible patients presented within 8 h of onset with proximal or distal LVOs, and the Tron FX 4/20 mm or 2/15 mm were used as the first-line device.

METHODS

The primary endpoints were rate of modified Thrombolysis in Cerebral Infarction (mTICI) grade 2a-3 immediately after using Tron FX only, and mortality rate 90 d. We compared the outcomes between sizes 4/20 and 2/15 mm.

RESULTS

The clinical trial was conducted in 50 cases, of which 44% presented with distal LVO and 15 cases were treated using only Tron FX 2/15 mm. The overall rate of mTICI grade 2a-3 was 80.0% (75.8% with Tron FX 4/20 mm, and 86.7% with 2/15 mm), and a 90-day modified Rankin Scale ≤ 2 or improvement of National Institute of Health Stroke Scale after thrombectomy ≥ 10 was achieved in 66.7% of cases (61.3% with Tron FX 4/20 mm, and 80.0% with 2/15 mm). The overall 90-day mortality rate was 8.0%, and symptomatic intracranial hemorrhage within 24 h occurred in 2.0% of cases.

CONCLUSION

In this clinical trial using the Tron FX, which included the size of 2/15 mm for distal LVO, its efficacy was similar and its safety was superior compared with previous studies.

摘要

背景

在所有机械取栓的随机对照试验中,目标血管均为近端血管。在此,我们报告了一项 Tron FX 支架取栓器的临床试验,其中包括最小尺寸为 2/15mm 的远端颅内大血管闭塞(LVO)。

目的

符合条件的患者在发病后 8 小时内出现近端或远端 LVO,首先使用 Tron FX 4/20mm 或 2/15mm 作为一线设备。

方法

主要终点为仅使用 Tron FX 即刻后改良脑梗死溶栓(mTICI)分级 2a-3 的比例,以及 90 天死亡率。我们比较了 4/20mm 和 2/15mm 两种尺寸的结果。

结果

该临床试验共纳入 50 例患者,其中 44%为远端 LVO,15 例仅使用 Tron FX 2/15mm 治疗。总体 mTICI 分级 2a-3 的比例为 80.0%(Tron FX 4/20mm 为 75.8%,2/15mm 为 86.7%),90 天改良 Rankin 量表评分≤2 或国立卫生研究院卒中量表评分在取栓后提高≥10 的比例为 66.7%(Tron FX 4/20mm 为 61.3%,2/15mm 为 80.0%)。总的 90 天死亡率为 8.0%,24 小时内症状性颅内出血发生率为 2.0%。

结论

在这项使用 Tron FX 的临床试验中,包括了远端 LVO 的 2/15mm 尺寸,其疗效与既往研究相似,安全性更优。

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