A multicenter, propensity score-matched analysis of functional outcomes and recanalization success with or without Trevo for Medium and distal vessel occlusion

James E. Siegler; Manisha Koneru; Hamza Shaikh; Hamza Adel Salim; Basel Musmar; Nimer Adeeb; Vivek Yedavalli; Motaz Daraghma; Kareem El Naamani; Nils Henninger; Sri Hari Sundararajan; Anna Luisa Kuehn; Sherief Ghozy; Luca Scarcia; Benjamin Y. Q. Tan; Jeremy J. Heit; Robert W. Regenhardt; Rami Z. Morsi; Tareq Kass-Hout; Nicholas Vigilante; Nicole M. Cancelliere; Joshua D. Bernstock; Aymeric Rouchaud; Jens Fiehler; Sunil A. Sheth; Muhammed Amir Essibayi; Ajit S. Puri; Christian Dyzmann; Marco Colasurdo; Xavier Barreau; Leonardo Renieri; Joao Pedro Filipe; Pablo Harker; Razvan Alexandru Radu; Thomas R. Marotta; Julian Spears; Takahiro Ota; Ashkan Mowla; Pascal Jabbour; Arundhati Biswas; Frederic Clarencon; Piers Klein; Mohamad Abdalkader; Thanh N. Nguyen; Ricardo Varela; Amanda Baker; David Altschul; Nestor R. Gonzalez; Markus A. Moehlenbruch; Vincent Costalat; Benjamin Gory; Christian Paul Stracke; Constantin Hecker; Christoph J. Griessenauer; David S. Liebeskind; Alessandro Pedicelli; Andrea M. Alexandre; Illario Tancredi; Tobias D. Faizy; Erwah Kalsoum; Boris Lubicz; Aman B. Patel; Vitor Mendes Pereira; Jane Khalife; Ankit Rana; Adrien Guenego; Adam A. Dmytriw; for the MAD MT Investigators

doi:10.1177/15910199251341603

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A multicenter, propensity score-matched analysis of functional outcomes and recanalization success with or without Trevo for Medium and distal vessel occlusion

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A multicenter, propensity score-matched analysis of functional outcomes and recanalization success with or without Trevo for Medium and distal vessel occlusion

James E. Siegler, Manisha Koneru, Hamza Shaikh, Hamza Adel Salim, Basel Musmar, Nimer Adeeb, Vivek Yedavalli, Motaz Daraghma, Kareem El Naamani, Nils Henninger, …

Interventional neuroradiology, p.15910199251341603

21/05/2025

DOI: https://doi.org/10.1177/15910199251341603

PMID: 40398470

Résumé

Clinical Neurology

Life Sciences & Biomedicine

Neurosciences & Neurology

Radiology, Nuclear Medicine & Medical Imaging

Science & Technology

Background Endovascular therapy (EVT) for stroke due to distal or medium vessel occlusion (DMVO) is safe. Due to the distinct anatomical characteristics of DMVOs, further evaluation of EVT is crucial to determine which devices may yield better outcomes. Methods A retrospective analysis of adults with DMVO treated in 37 centers (11 countries) was queried. The primary outcome of favorable shift in 90-day modified Rankin Scale (mRS) was compared between patients treated with Trevo versus other devices on first pass using 1:1 propensity score matching (PSM) with multivariable adjustment. Secondary outcomes included the number of pass attempts, final thrombolysis in cerebral infarction (TICI) score 2b-3, symptomatic intracranial hemorrhage (sICH), improvement in National Institutes of Health Stroke Scale (NIHSS) at 24h, and 90-day mortality. Results Of the 1115 included patients, 264 (24%) were treated with Trevo (PSM cohort of 261 per group). Trevo use was not associated with a favorable 90-day mRS shift (proportional odds ratio [OR] 1.10, 95% confidence interval [CI] 0.80-1.51). Trevo was associated with fewer passes (adjusted beta=-0.25, 95% CI -0.48 - -0.03), higher odds of TICI 2b-3 (adjusted OR 1.97, 95% CI 1.11-3.49), and a greater 24h NIHSS improvement (adjusted beta= -1.74, 95% CI -3.11 - -0.36), with no difference in sICH or mortality (p>0.05). Results were similar in sensitivity analyses. Conclusions We observed no safety concerns with Trevo as compared to other EVT devices for DMVO recanalization. There was a signal of better technical efficacy and early clinical improvement.

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Détails

Titre: A multicenter, propensity score-matched analysis of functional outcomes and recanalization success with or without Trevo for Medium and distal vessel occlusion
Créateurs - sans rôle: James E. Siegler - Rowan University
Manisha Koneru - Rowan Univ, Cooper Univ Hosp, Cooper Neurol Inst, Cooper Med Sch, Camden, NJ 08103 USA
Hamza Shaikh - Rowan University
Hamza Adel Salim - College Station Medical Center
Basel Musmar - Louisiana State University
Nimer Adeeb - Louisiana State University
Vivek Yedavalli - College Station Medical Center
Motaz Daraghma - Harvard Med Sch, Massachusetts Gen Hosp, Brigham & Womens Hosp, Boston, MA 02115 USA
Kareem El Naamani - Thomas Jefferson Univ, Dept Neurosurg, Philadelphia, PA 19107 USA
Nils Henninger - Univ Massachusetts, Chan Med Sch, Dept Psychiat, Worcester, MA USA
Sri Hari Sundararajan - Dept Endovascular Neurosurg & Neuroradiol NJMS, Newark, NJ USA
Anna Luisa Kuehn - Univ Massachusetts, Med Ctr, Dept Radiol, Div Neurointervent Radiol, Worcester, MA USA
Sherief Ghozy - Biostat
Luca Scarcia - Henri Mondor Hosp, Dept Neuropathol, F-94000 Creteil, France
Benjamin Y. Q. Tan - Natl Univ Singapore, Yong Loo Lin Sch Med, Dept Med, Singapore, Singapore
Jeremy J. Heit - College Station Medical Center
Robert W. Regenhardt - Harvard Med Sch, Massachusetts Gen Hosp, Brigham & Womens Hosp, Boston, MA 02115 USA
Rami Z. Morsi - Univ Chicago, Dept Neurol, Chicago, IL 61801 USA
Tareq Kass-Hout - Univ Chicago, Dept Neurol, Chicago, IL 61801 USA
Nicholas Vigilante - Univ Chicago, Dept Neurol, Chicago, IL 61801 USA
Nicole M. Cancelliere - University of Toronto
Joshua D. Bernstock - Harvard Med Sch, Dept Neurosurg, Brigham & Womens Hosp, Boston, MA USA
Aymeric Rouchaud - Univ Limoges, Dept Gastroenterol, Dupuytren Univ Hosp, CNRS,XLIM, Limoges, France
Jens Fiehler - Univ Massachusetts, Med Ctr, Dept Radiol, Div Neurointervent Radiol, Worcester, MA USA
Sunil A. Sheth - UTHealth, McGovern Med Sch, Dept Neurol, Houston, TX USA
Muhammed Amir Essibayi - Albert Einstein College of Medicine
Ajit S. Puri - College Station Medical Center
Christian Dyzmann - Sana Kliniken Luebeck GmbH, Lubeck, Germany
Marco Colasurdo - University of Portland
Xavier Barreau - Bordeaux Univ Hosp, Intervent & Diagnost Neuroradiol Dept, Bordeaux, France
Leonardo Renieri - Azienda Osped Univ Careggi Firenze, Radioterapia, Florence, Italy
Joao Pedro Filipe - Ctr Hospitalar Univ Porto, Dept Cardiol, Porto, Portugal
Pablo Harker - University of Cincinnati
Razvan Alexandru Radu - Montpellier Univ Med Ctr, Gui Chauliac Hosp, Dept Neuroradiol, Montpellier, France
Thomas R. Marotta - University of Toronto
Julian Spears - Univ Toronto, St Michael Hosp, Neurovasc Ctr, Div Therapeut Neurosurg, Toronto, ON, Canada
Takahiro Ota - Tokyo Metropolitan Tama Med Ctr, Dept Neurosurg, Tokyo, Japan
Ashkan Mowla - Univ Southern Calif, Keck Sch Med USC, Dept Neurol Surg, Los Angeles, CA 90033 USA
Pascal Jabbour - Thomas Jefferson University
Arundhati Biswas - New York Medical College
Frederic Clarencon - Sorbonne Univ, Pitie Salpetriere Hosp, APHP, Dept Neuroradiol, Paris, France
Piers Klein - College Station Medical Center
Mohamad Abdalkader - College Station Medical Center
Thanh N. Nguyen - Boston Med Ctr, Pulm Ctr, Boston, MA USA
Ricardo Varela - Ctr Hospitalar Univ Porto, Dept Cardiol, Porto, Portugal
Amanda Baker - Albert Einstein College of Medicine
David Altschul - Albert Einstein College of Medicine
Nestor R. Gonzalez - College Station Medical Center
Markus A. Moehlenbruch - Klin Anasthesiol, Universitatsklinikum Heidelberg, Heidelberg, Germany
Vincent Costalat - Montpellier Univ Med Ctr, Gui Chauliac Hosp, Dept Neuroradiol, Montpellier, France
Benjamin Gory - Univ Hosp Nancy, Dept Diagnost & Intervent Neuroradiol, Nancy, France
Christian Paul Stracke - Univ Med Ctr Munster, Dept Radiol, Neuroendovasc Div, Munster, Germany
Constantin Hecker - Paracelsus Med Univ, Dept Neurosurg, Christian Doppler Clin, Salzburg, Austria
Christoph J. Griessenauer - Paracelsus Med Univ, Dept Neurosurg, Christian Doppler Clin, Salzburg, Austria
David S. Liebeskind - UCLA Stroke Ctr, Dept Neurol, Los Angeles, CA 90095 USA
Alessandro Pedicelli - Fdn Policlin Univ A Gemelli, IRCCS Roma, Dipartimento Diag Immagini Radioterapia Oncol, Rome, Italy
Andrea M. Alexandre - Fdn Policlin Univ A Gemelli, IRCCS Roma, Dipartimento Diag Immagini Radioterapia Oncol, Rome, Italy
Illario Tancredi - Hop Civil Marie Curie, Neurol, Charleroi, Belgium
Tobias D. Faizy - Univ Med Ctr Munster, Dept Radiol, Neuroendovascular Program, Munster, Germany
Erwah Kalsoum - Henri Mondor Hosp, Dept Neuropathol, F-94000 Creteil, France
Boris Lubicz - Erasme Univ Hosp, Dept Intervent Neuroradiol, B-1070 Brussels, Belgium
Aman B. Patel - Harvard Med Sch, Massachusetts Gen Hosp, Brigham & Womens Hosp, Boston, MA 02115 USA
Vitor Mendes Pereira - University of Toronto
Jane Khalife - Rowan University
Ankit Rana - Rowan Univ, Cooper Univ Hosp, Cooper Neurol Inst, Cooper Med Sch, Camden, NJ 08103 USA
Adrien Guenego - Erasme Univ Hosp, Dept Intervent Neuroradiol, B-1070 Brussels, Belgium
Adam A. Dmytriw - Harvard Med Sch, Massachusetts Gen Hosp, Brigham & Womens Hosp, Boston, MA 02115 USA
for the MAD MT Investigators
Détails de publication: Interventional neuroradiology, p.15910199251341603
Éditeur: Sage
Nombre de pages: 9
Note de subvention: R61NS135583; NS131756; NR020231; U24NS113844; NS065743 / National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA W81XWH-20-1-0271 / CDMRP of the Department of Defense
Identifiants: 99163122309311
Unité académique: Institut de Génomique Fonctionnelle - IGF
Langue: English
Type de ressource: Journal article