Thrombectomy using the EmboTrap device: core laboratory-assessed results in 201 consecutive patients in a real-world setting

医学 溶栓 血运重建 改良兰金量表 单变量分析 内科学 人口 外科 单中心 闭塞 多元分析 冲程(发动机) 缺血性中风 缺血 心肌梗塞 工程类 环境卫生 机械工程
作者
Patrick A. Brouwer,Leonard L.L. Yeo,Åke Holmberg,Tommy Andersson,Jens Kolloch,Åsa Kuntze Söderqvist,Marcus Ohlsson,Staffan Holmin,Anastasios Mpotsaris,Vamsi Gontu,Paul Bhogal,Michael Söderman
出处
期刊:Journal of NeuroInterventional Surgery [BMJ]
卷期号:10 (10): 964-968 被引量:15
标识
DOI:10.1136/neurintsurg-2018-013765
摘要

We studied patients treated with the EmboTrap revascularization device in a prospective registry which is core laboratory evaluated by physicians from external centers. The goal was to determine how the EmboTrap would perform under the everyday conditions of a high-volume stroke center.We examined all patients with acute stroke treated with the Embotrap device from October 2013 to March 2017 in our center. Imaging parameters and times were adjudicated by core laboratory personnel blinded to clinical information, treating physician, and clinical outcomes. Clinical evaluation was performed by independent neurologists and entered in a national registry. Evaluated endpoints were: successful revascularization (modified Thrombolysis in Cerebral Infarction (mTICI) 2b-3) and good clinical outcomes at 3 months (modified Rankin Scale (mRS) 0-2).201 consecutive patients with a median NIH Stroke Scale (NIHSS) score of 15 (range 2-30) were included. 170 patients (84.6%) achieved mTICI 2b-3 reperfusion. The median number of attempts was 2 (range 1-10) with 52.8% of the population achieving good functional outcomes (mRS 0-2) at 3 months. On univariate analysis, good functional outcome was associated with the number of attempts, puncture-to-reperfusion time, anterior circulation occlusion, and NIHSS score. On multivariate analysis, pre-treatment NIHSS (OR 0.845 per point, 95% CI 0.793 to 0.908, P<0.001) and puncture-to-reperfusion time (OR 0.9952 per min, 95% CI 0.9914 to 0.9975, P=0.023) were associated with good functional outcomes at 3 months.The Embotrap device has a high rate of successful reperfusion. Our core laboratory-audited single-center experience suggests the technical feasibility and safety of the Embotrap for first-line use in a real-world setting.
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