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- W2912665128 abstract "Introduction: The optimal approach for distal intracranial occlusions in thrombectomy for acute ischemic stroke is unclear. We aim to compare our experience with 3mmx20 Trevo Retriever against the Penumbra 3max in small vessels. Methods: Retrospective review of a prospective thrombectomy databank for consecutive cases of use of 3mmx20 Trevo Retriever or Penumbra 3max for middle cerebral artery (MCA) mid or distal M2, M3, anterior cerebral artery (ACA A1, A2, A3) or posterior cerebral artery (PCA P1, P2) from Jan 2014-July 2018. Results: Of 1071 patients treated within the study period, 136 patients/144 different arteries underwent treatment with small devices (3mmTrevo n=92 vs 3Max n=52). There was no difference in the distal occlusion presentation: isolated distal occlusion, emboli to new or same distal territory, or multiple occlusions (p=0.11). The distribution of occlusions site was comparable (p=0.37). Demographics were comparable including age, gender, hypertension, atrial fibrillation, systolic blood pressure, last-normal to puncture. The use of intravenous alteplase was similar (p=0.47) as well as the use of balloon guide catheter (p=1.00). The approached vessel pre-clot diameter was comparable between the 3mmTrevo and 3Max groups (1.6±0.2mm vs 1.4±0.3;p=0.66), respectively. The frequency of superior vs inferior vs middle MCA division was similar (p=0.42) amongst arms. A trend for higher first-pass mTICI2b-3 reperfusion was noted in the 3mmTrevo (62% vs 44%;p=0.05) vs 3Max group. Rates of first-pass full reperfusion was comparable (42% vs 34%;p=0.38). Adjuvant therapy was used less frequently in the 3mm Trevo group (15% vs 31%;p=0.03) for comparable final mTICI3 rates (p=0.22). The number of passes (1.3±0.5 vs 1.3±0.6; p=0.9) and the frequency of arterial spasm (any spasm; p=1.00) were comparable between groups. 90-day rates of good outcomes (35/76 vs 21/43; p=0.84) were comparable amongst arms. Subarachnoid hemorrhage (p=0.37) and parenchymal hematomas (p=0.21) in the territory of approached vessel was similar. Conclusions: The 3mm Trevo may lead to enhanced rates of successful reperfusion as compared to 3Max thromboaspiration. Further studies are warranted." @default.
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- W2912665128 date "2019-02-01" @default.
- W2912665128 modified "2023-10-14" @default.
- W2912665128 title "Abstract TP32: 3mmx20 Trevo Retriever vs. Penumbra 3 Max Distal Occlusion Acute Stroke Thrombectomy" @default.
- W2912665128 doi "https://doi.org/10.1161/str.50.suppl_1.tp32" @default.
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