Etter Manina M, Möhlenbruch Markus, Weyland Charlotte S, Pérez-García Carlos, Moreu Manuel, Capasso Francesco, Limbucci Nicola, Nikoubashman Omid, Wiesmann Martin, Blackham Kristine, Tsogkas Ioannis, Sporns Peter, Ospel Johanna Maria, Brehm Alex, Psychogios Marios-Nikos
Department of Neuroradiology, Clinic for Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland.
Department of Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany.
Front Neurol. 2021 Jul 16;12:704329. doi: 10.3389/fneur.2021.704329. eCollection 2021.
The application of a new coating to the delivery wire of the Trevo retriever has the potential to improve its handling. We therefore report our initial experience with this new stent retriever for mechanical thrombectomy of large and medium vessel occlusions. We pooled data of four high-volume European stroke centers over the time period from October 2020 to February 2021. Patients were included in our study if the Trevo NXT stent retriever was used as a first-line device. Primary endpoints were first-pass near-complete or complete reperfusion, defined as mTICI score of ≥2c. Secondary endpoints were final reperfusion, National Institutes of Health Stroke Scale (NIHSS) at 24 h and discharge, device malfunctions, complications during the procedure, and subjective ratings of the interventionalists regarding device functionality. Eighty patients (39 women, mean age 74 ± 14 years) were eligible for our study. Median NIHSS at admission was 15 (IQR, 8-19), and median Alberta Stroke Program Early CT Score at baseline was 9 (IQR, 8-10). In 74 (93%) patients a primary combined approach was used as first-line technique. First-pass near-complete reperfusion was achieved in 43 (54%) and first-pass complete reperfusion in 34 (43%) patients. Final near-complete reperfusion was achieved in 66 (83%) patients after a median of 1.5 (1-3) passes, while final successful reperfusion was observed in 96% of our cases. We observed no device malfunctions. Median NIHSS at discharge was 2 (IQR, 0-5), and 3 patients (4%) suffered a symptomatic intracranial hemorrhage. Based on our initial data, we conclude that the Trevo NXT is an effective and safe tool for mechanical thrombectomy especially when used for combined approaches.
在Trevo取栓器的输送导丝上应用一种新涂层有可能改善其操作性。因此，我们报告了使用这种新型支架取栓器进行大中型血管闭塞机械取栓的初步经验。我们汇总了2020年10月至2021年2月期间四个高容量欧洲卒中中心的数据。如果将Trevo NXT支架取栓器用作一线设备，则将患者纳入我们的研究。主要终点是首次通过时接近完全或完全再灌注，定义为改良脑梗死溶栓（mTICI）评分≥2c。次要终点是最终再灌注、24小时和出院时的美国国立卫生研究院卒中量表（NIHSS）评分、设备故障、手术过程中的并发症以及介入医生对设备功能的主观评价。80例患者（39名女性，平均年龄74±14岁）符合我们的研究条件。入院时NIHSS中位数为15（四分位间距，8 - 19），基线时阿尔伯塔卒中项目早期CT评分中位数为9（四分位间距，8 - 10）。74例（93%）患者采用了主要的联合方法作为一线技术。43例（54%）患者实现了首次通过时接近完全再灌注，34例（43%）患者实现了首次通过时完全再灌注。在中位数为1.5（1 - 3）次通过后，66例（83%）患者实现了最终接近完全再灌注，而我们96%的病例观察到最终成功再灌注。我们未观察到设备故障。出院时NIHSS中位数为2（四分位间距，0 - 5），3例患者（4%）发生了有症状的颅内出血。基于我们的初步数据，我们得出结论，Trevo NXT是一种有效且安全的机械取栓工具，尤其是用于联合方法时。
