TY - JOUR
T1 - Japan trevo registry
T2 - Real-world registry of stent retriever alone or in combined therapy with aspiration catheter for acute ischemic stroke in Japan
AU - Japan Trevo Registry Investigators
AU - Uchida, Kazutaka
AU - Sakai, Nobuyuki
AU - Yamagami, Hiroshi
AU - Uemura, Kohei
AU - Imamura, Hirotoshi
AU - Takeuchi, Masataka
AU - Shirakawa, Manabu
AU - Sakakibara, Fumihiro
AU - Haraguchi, Koichi
AU - Kimura, Naoto
AU - Suzuki, Kentaro
AU - Ayabe, Junichi
AU - Yamamoto, Daisuke
AU - Shindo, Seigo
AU - Kimoto, Atsushi
AU - Morita, Kenichi
AU - Akiyama, Yoshinori
AU - Takezawa, Hidesato
AU - Toyota, Shingo
AU - Tanaka, Kanta
AU - Kasakura, Shigen
AU - Tsukagoshi, Eisuke
AU - Ueda, Toshihiro
AU - Yoshimura, Shinichi
AU - Nomura, Tatsufumi
AU - Ogino, Tatsuya
AU - Haraguchi, Koichi
AU - Kinoshita, Yu
AU - Haraguchi, Kenichi
AU - Gekka, Masayuki
AU - Suzuki, Ichiro
AU - Kimura, Naoto
AU - Matsumoto, Yasushi
AU - Yoshida, Masahiro
AU - Kondo, Rei
AU - Sato, Naoki
AU - Ikeda, Go
AU - Watanabe, Daisuke
AU - Akutsu, Yoshimitsu
AU - Matsumaru, Yuji
AU - Yoshimura, Masataka
AU - Kakumoto, Kosuke
AU - Kasakura, Shigen
AU - Tsukagoshi, Eisuke
AU - Hyodo, Akio
AU - Hayasaka, Michihiro
AU - Miyazaki, Tadashi
AU - Yamauchi, Toshihiro
AU - Suzuki, Kentaro
AU - Nakahara, Ichito
N1 - Publisher Copyright:
© 2023 The Japan Neurosurgical Society.
PY - 2023
Y1 - 2023
N2 - Endovascular therapy (EVT) for real-world patients after extended time frames is associated with concerns about its efficacy and safety. We conducted a prospective registry at 77 centers between November 2019 and October 2020. The registry criteria included patients treated with Trevo Retriever alone or in combined therapy with an aspiration catheter. The primary outcome was effective reperfusion (thrombolysis in cerebral infarction grade ≥2b), the secondary outcome was a modified Rankin scale 0-2 at 90 days, and the safety outcomes were worsening of neurologic symptoms within 24 h postoperatively, intracranial hemorrhage (ICH) within 24 h after EVT and mortality. We also exlpored the difference between patients whose last known well time (LKWT) to a puncture was less than 6 h (0-6 h) and those whose LKWT was 6 h or more but less than 24 h (6-24 h). Among the 1041 patients registered, 1025 patients were analyzed. The mean age was 76.9 years, and 53.6% of the participants were males. The 6-24 h group was 206/998 (20.6%), the median National Institute of Health Stroke Scale (NIHSS) score at admission was 18, and the median Alberta Stroke Program Early CT score was 8. Combined technique as the first pass was used on 817 (79.7%) patients. The primary outcome was 934 (91.1%). The secondary outcome was 433/1021 (42.4%). Symptomatic ICH, any ICH, and mortality were 10/1019 (1.0%), 311/1019 (30.5%), and 75 (7.3%). In the subanalysis, the 6-24 h group was lower in NIHSS (median;18 vs 16), and the secondary outcome was not significantly different in the <6 h group. Even after treatment time expansion, this result was comparable to other Trevo-based trials and nationwide registries.
AB - Endovascular therapy (EVT) for real-world patients after extended time frames is associated with concerns about its efficacy and safety. We conducted a prospective registry at 77 centers between November 2019 and October 2020. The registry criteria included patients treated with Trevo Retriever alone or in combined therapy with an aspiration catheter. The primary outcome was effective reperfusion (thrombolysis in cerebral infarction grade ≥2b), the secondary outcome was a modified Rankin scale 0-2 at 90 days, and the safety outcomes were worsening of neurologic symptoms within 24 h postoperatively, intracranial hemorrhage (ICH) within 24 h after EVT and mortality. We also exlpored the difference between patients whose last known well time (LKWT) to a puncture was less than 6 h (0-6 h) and those whose LKWT was 6 h or more but less than 24 h (6-24 h). Among the 1041 patients registered, 1025 patients were analyzed. The mean age was 76.9 years, and 53.6% of the participants were males. The 6-24 h group was 206/998 (20.6%), the median National Institute of Health Stroke Scale (NIHSS) score at admission was 18, and the median Alberta Stroke Program Early CT score was 8. Combined technique as the first pass was used on 817 (79.7%) patients. The primary outcome was 934 (91.1%). The secondary outcome was 433/1021 (42.4%). Symptomatic ICH, any ICH, and mortality were 10/1019 (1.0%), 311/1019 (30.5%), and 75 (7.3%). In the subanalysis, the 6-24 h group was lower in NIHSS (median;18 vs 16), and the secondary outcome was not significantly different in the <6 h group. Even after treatment time expansion, this result was comparable to other Trevo-based trials and nationwide registries.
KW - Endovascular therapy
KW - Intracranial hemorrhage
KW - Large vessel occlusion
KW - Trevo Retriever
UR - http://www.scopus.com/inward/record.url?scp=85180187485&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85180187485&partnerID=8YFLogxK
U2 - 10.2176/jns-nmc.2023-0069
DO - 10.2176/jns-nmc.2023-0069
M3 - Article
C2 - 37853613
AN - SCOPUS:85180187485
SN - 0470-8105
VL - 63
SP - 503
EP - 511
JO - neurologia medico-chirurgica
JF - neurologia medico-chirurgica
IS - 11
ER -