Faculty Collaboration Database

Trevo 2000: Results of a Large Real-World Registry for Stent Retriever for Acute Ischemic Stroke. J Am Heart Assoc 2018 Dec 18;7(24):e010867

Date

12/19/2018

Pubmed ID

30561262

Pubmed Central ID

PMC6405611

DOI

10.1161/JAHA.118.010867

Scopus ID

2-s2.0-85058750576 (requires institutional sign-in at Scopus site)   41 Citations

Abstract

Background Recent randomized controlled trials show benefit of thrombectomy for large vessel occlusion in stroke. Real-world data aid in assessing reproducibility of outcomes outside of clinical trials. The Trevo Retriever Registry is a multicenter, international, prospective study designed to assess outcomes in a large cohort of patients. Methods and Results The Trevo Registry is a prospective database of patients with large vessel occlusion treated with the Trevo device as the first device. The primary end point is revascularization based on modified Thrombolysis in Cerebral Infarction score and secondary end points include 90-day modified Rankin Scale, 90-day mortality, neurological deterioration at 24 hours, and device/procedure related adverse events. Year 2008 patients were enrolled at 76 centers in 12 countries. Median admission National Institutes of Health Stroke Scale was 16 (interquartile range, 11-20). Occlusion sites were internal carotid artery (17.8%), middle cerebral artery (73.5%), posterior circulation (7.1%), and distal vascular locations (1.6%). A modified Thrombolysis in Cerebral Infarction 2b or 3 was achieved in 92.8% (95% CI, 91.6, 93.9) of procedures, with 55.3% (95% CI, 53.1, 57.5) of patients achieving modified Rankin Scale ≤2 at 3 months. Patients meeting revised 2015 American Heart Association criteria for thrombectomy had a 59.7% (95% CI , 56.0; 63.4) modified Rankin Scale 0 to 2 at 3 months, whereas 51.4% treated outside of American Heart Association criteria had modified Rankin Scale 0 to 2. 51.4% (95% CI , 49.6, 55.4). Symptomatic intracranial hemorrhage rate was 1.7% (95% CI , 1.2, 2.4). Conclusions The Trevo Retriever Registry represents real-world data with stent retriever. The registry demonstrates similar reperfusion rates and outcomes in the community compared with rigorous centrally adjudicated clinical trials. Future subgroup analysis of this cohort will assist in identifying areas of future research. Clinical Trial Registration URL : https://www.clinicaltrials.gov . Unique identifier: NCT 02040259.

Author List

Binning MJ, Bartolini B, Baxter B, Budzik R, English J, Gupta R, Hedayat H, Krajina A, Liebeskind D, Nogueira RG, Shields R, Veznedaroglu E

Author

Hirad S. Hedayat MD Associate Professor in the Neurosurgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Aged, 80 and over
Brain Ischemia
Databases, Factual
Disability Evaluation
Endovascular Procedures
Female
Humans
Male
Middle Aged
Prospective Studies
Prosthesis Design
Recovery of Function
Registries
Risk Factors
Stents
Stroke
Thrombectomy
Time Factors
Treatment Outcome