Effectiveness of Trevo stent retriever in acute ischemic stroke

Abstract

Recently, mechanical thrombectomy with stent retriever has achieved faster and higher rates of recanalization for intracranial major vessel occlusion. However, comparative studies of the most widely used Solitaire and Trevo stents have been rarely published.The authors retrospectively reviewed a total of 200 patients who performed mechanical thrombectomy at our center during 4 years and divided patients into 2 groups: mechanical thrombectomy with Solitaire stent (Group 1: Solitaire) and mechanical thrombectomy with Trevo stent (Group 2: Trevo). All patients underwent a clinical assessment with National Institutes of Health Stroke Scale (NIHSS) score and underwent modified Rankin Scale (mRS) score. Radiologic results were evaluated using thrombolysis in cerebral infarction (TICI) score and number of stent passes. In addition, multiple time intervals were analyzed.There was no statistically significant difference in clinical outcome between the 2 groups. Trevo group revealed the shorter procedure time, less number of stent passage, and more one pass cases than Solitaire group with statistically significance (P = .009, P = .014, P = .030). In addition, Trevo group achieved higher successful recanalization (TICI 2b or 3) rate (89.7%) with statically significant than group1 (82.3%) (P = .018). In multivariate logistic regression analysis, the use of Trevo stent was a predictive for successful recanalization. (odds ratio 1.40, 95% confidence interval 1.250–1.550, P = .028).Our study suggests that the Trevo stent allows higher recanalization rate through the less number of stent passages and shorter procedure time than the Solitaire stent. More randomized control trials are needed to determine which stents are more effective.

Initial Experience With the Trevo NXT Stent Retriever

“…In this retrospective multicenter study, we evaluated the initial results with this new device. One of our main findings was that the rate of first-pass complete or near-complete reperfusion (mTICI ≥2c) was achieved in 54% of cases, which compares favorably to previously published data of the predecessor retriever (Table 4) (13,14). Final mTICI ≥2c was achieved in 83%, and final complete reperfusion (mTICI 3) in 56% of the cases.…”

“…Mean age was 74 ± 14 years, and 39 patients (49%) were female. The median NIHSS at admission was 15(IQR,(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19).…”

Thrombectomy for Acute Ischemic Stroke With a New Device-Skyflow: Study Protocol for a Prospective, Multicenter, Stratified Randomized, Single-Blinded, Parallel, Positive Controlled, Non-inferiority Clinical Trial

“…Stent retriever has recently been widely used for thrombectomy, and has been reported to be associated with faster reperfusion and higher rate of successful recanalization in endovascular treatment of intracranial LVO (19). However, the research and development of domestic stent retrievers is relatively slow and few devices have been verified by clinical trials (15), which greatly hinders the progress of endovascular treatment in China.…”

The Long-Term Functional Effect of Thrombectomy on Patients with Middle Cerebral Artery Occlusion Who Exhibit Moderate to Severe Disability

“…Endovascular procedures were performed by three neuro-interventionists. EVT involved thrombus retraction with a 6-mm retrievable stent, such as a Solitaire FR (ev3/Covidien, Irvine, CA, USA) or Trevo XP ProVue (Stryker Neurovascular, Fremont, CA, USA) [17,18]. A balloon-guided catheter (Merci, Concentric Medical, Mountain View, CA, USA; or FlowGate2, Stryker Neurovascular) was used in some instances.…”