Castro-Afonso Luís Henrique de, Trivelato Felipe Padovani, Wajnberg Eduardo, Waihrich Eduardo Siqueira, Abud Thiago Giansante, Alves Saulo Villas Boas, Matsubara Anderson, Rezende Marco Tulio Salles, Araujo João Francisco Santoro, Nakiri Guilherme Seizem, Abud Daniel Giansante
Division of Interventional Neuroradiology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
Division of Interventional Neuroradiology, Instituto Neurovascular, Hospital Felicio Rocho, Belo Horizonte, MG, Brazil.
Interv Neuroradiol. 2025 May 13:15910199251342439. doi: 10.1177/15910199251342439.
IntroductionThrombectomy has become the standard treatment for acute ischemic stroke (AIS) caused by large vessel occlusions (LVOs). The Aperio Hybrid (Acandis, Pforzheim, Germany) is a new stent retriever designed to enhance the effectiveness of this treatment. However, this new stent has not yet been compared to other thrombectomy devices in a clinical setting. The aim of this study was to compare the Aperio Hybrid with the Solitaire™ FR/X (Medtronic, Minneapolis, USA) during thrombectomy in patients with AIS due to anterior circulation LVO.Materials and methodsWe analyzed data from a multicenter registry of thrombectomy for anterior circulation LVO. Patients with carotid/M1 or proximal M2 occlusions who underwent thrombectomy with either the Aperio Hybrid or Solitaire™ FR/X were compared using propensity-score matching (PSM). The primary outcome was the recanalization rate, measured by the Treatment in Cerebral Ischemia (TICI) score of 2b-3, while the secondary outcome was the rate of symptomatic intracranial hemorrhage (sICH).ResultsAmong 455 patients treated, after PSM, 258 patients (129 per group) were analyzed. The adjusted recanalization rates (TICI 2b-3) for the Aperio Hybrid and Solitaire FR/X were 79.8% and 75.9%, respectively ( = .08), while the adjusted sICH rates were 6.9% and 6.2%, respectively ( = .80).ConclusionsIn this observational study on thrombectomy for AIS, the Aperio Hybrid and Solitaire FR/X demonstrated similar rates of recanalization and symptomatic intracranial hemorrhage. However, due to significant selection bias, these results should be interpreted with caution.
引言
血栓切除术已成为治疗由大血管闭塞（LVO）引起的急性缺血性卒中（AIS）的标准疗法。Aperio Hybrid（德国普福尔茨海姆的Acandis公司生产）是一种新型取栓支架，旨在提高该治疗的有效性。然而，这种新型支架尚未在临床环境中与其他取栓装置进行比较。本研究的目的是在因前循环LVO导致的AIS患者进行血栓切除术期间，将Aperio Hybrid与Solitaire™ FR/X（美国明尼阿波利斯的美敦力公司生产）进行比较。
材料与方法
我们分析了来自前循环LVO血栓切除术多中心登记处的数据。使用倾向评分匹配（PSM）比较接受Aperio Hybrid或Solitaire™ FR/X血栓切除术的颈动脉/M1或近端M2闭塞患者。主要结局是再通率，通过脑缺血治疗（TICI）2b - 3级评分来衡量，次要结局是有症状颅内出血（sICH）率。
结果
在455例接受治疗的患者中，经过PSM后，分析了258例患者（每组129例）。Aperio Hybrid和Solitaire FR/X的调整后再通率（TICI 2b - 3）分别为79.8%和75.9%（P = 0.08），而调整后的sICH率分别为6.9%和6.2%（P = 0.80）。
结论
在这项关于AIS血栓切除术的观察性研究中，Aperio Hybrid和Solitaire FR/X显示出相似的再通率和有症状颅内出血率。然而，由于存在显著的选择偏倚，这些结果应谨慎解释。
