Abstract Number ‐ 189: Comparative Device Analysis for First Pass Stent Retriever Mechanical Thrombectomy

Introduction Limited data is available regarding comparative outcomes amongst FDA‐approved devices for mechanical thrombectomy (MT). The objective of this study is to assess procedural efficacy, clinical outcomes, and safety of currently available stent retriever devices when used during first pass thrombectomy for acute ischemic stroke. Methods A retrospective analysis was performed on all patients who underwent MT for large vessel occlusion (LVO) at a single comprehensive stroke center between January 2016 and January 2022. All patients who underwent MT with a stent retriever (Solitaire, Embotrap, Trevo) during first pass were included in the analysis. Primary efficacy and safety outcomes included time to recanalization, attainment of first‐pass effect (FPE), recanalization TICI score, 90‐day modified Rankin scale (mRS), and incidence of hemorrhagic transformation. One‐way ANOVA was used to compare median time to recanalization amongst cohorts. Chi‐squared test was used to compare frequencies of outcome measures amongst cohorts. Results During the study period, 234 patients underwent MT for LVO with use of stent retriever device during the first pass. In these cases, the type of stent retriever utilized was Solitaire (n = 163), Embotrap (n = 45), or Trevo (n = 26). There were no significant differences between cohorts in terms of age, gender, ethnicity, initial NIH stroke scale, or level of occlusion, or comorbidities. No significant differences were observed between cohorts for any primary outcome measures. The median time to recanalization was 53 min [Solitaire], 49 min [Embotrap], 63 min [Trevo] (p = 0.17). First‐pass effect was attained in 28.6% [Solitaire], 38.4% [Embotrap], 26.9% [Trevo] (p = 0.41). TICI 2b or greater recanalization was attained in 80.3% [Solitaire], 88.9% [Embotrap], 84.6% [Trevo] (p = 0.38). 90‐day mRS of 0–2 was observed in 36.6% [Solitaire], 38.9% [Embotrap], 34.8% [Trevo] (p = 0.95). Hemorrhagic transformation was observed in 45.9% [Solitaire], 36.8% [Embotrap], 34.6% [Trevo] (p = 0.40). Conclusions The type of stent retriever chosen for first pass thrombectomy did not predict procedural efficacy, clinical outcomes, or safety in our single center analysis.