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Original research
Embolus Retriever with Interlinked Cages (ERIC) versus conventional stent retrievers for thrombectomy: a propensity score-based analysis
  1. Célina Ducroux1,
  2. Nicolas Renaud2,
  3. Romain Bourcier2,
  4. Gaultier Marnat3,
  5. Igor Sibon4,
  6. Benjamin Gory5,
  7. Sébastien Richard6,
  8. Cyril Dargazanli7,
  9. Caroline Arquizan8,
  10. Francois Eugene9,
  11. Stephane Vannier10,
  12. Julien Labreuche11,
  13. Gregory Walker12,13,
  14. Raphaël Blanc1,
  15. Mickael Obadia14,
  16. Arturo Consoli15,
  17. Bertrand Lapergue16,
  18. Robert Fahed1,12
  19. for the ETIS investigators
    1. 1 Interventional Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
    2. 2 Neuroradiology, Centre Hospitalier Universitaire de Nantes, Nantes, Pays de la Loire, France
    3. 3 Interventional and Diagnostic Neuroradiology, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, Aquitaine, France
    4. 4 Neurology, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, Aquitaine, France
    5. 5 Diagnostic and Interventional Neuroradiology, Centre Hospitalier Régional Universitaire de Nancy, Nancy, Lorraine, France
    6. 6 Neurology Stroke Unit, Centre Hospitalier Régional Universitaire de Nancy, Nancy, France
    7. 7 Neuroradiology, Centre Hospitalier Universitaire Gui de Chauliac, Montpellier, Occitanie, France
    8. 8 Neurology, Centre Hospitalier Universitaire Gui de Chauliac, Montpellier, France
    9. 9 Neuroradiology, Centre Hospitalier Universitaire de Rennes, Rennes, France
    10. 10 Neurology, Centre Hospitalier Universitaire de Rennes, Rennes, France
    11. 11 Biostatistics, Centre Hospitalier Universitaire de Lille, Lille, France
    12. 12 Department of Medicine – Division of Neurology, Ottawa Hospital, Ottawa, Ontario, Canada
    13. 13 Department of Medicine – Division of Neurology, Royal Columbian Hospital, New Westminster, British Columbia, Canada
    14. 14 Neurology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, Île-de-France, France
    15. 15 Neuroradiology, Foch Hospital, Suresnes, Île-de-France, France
    16. 16 Neurology, Foch Hospital, Suresnes, France
    1. Correspondence to Dr Robert Fahed, Medicine - Neurology, Ottawa Hospital, Ottawa, ON K1Y 4E9, Canada; robert.fahed{at}hotmail.fr

    Abstract

    Background The Embolus Retriever with Interlinked Cages (ERIC) is one of the latest devices for thrombectomies. It has several architectural features that are supposed to enhance its ability to remove clots and prevent distal emboli. We aimed to compare ERIC with standard stent retrievers (SRs) using propensity score (PS) matching.

    Methods The clinical and radiological data of all consecutive patients treated with ERIC or standard FDA-approved stent retrievers were collected from a prospective multicenter registry. We compared procedural outcomes (recanalization rates according to the modified Thrombolysis In Cerebral Infarction (mTICI) score and procedural complications) and clinical outcomes (modified Rankin Scale (mRS) and mortality at 3 months). Matching of the populations with PS was performed to account for differences in baseline characteristics.

    Results A total of 1230 patients were included. In both the PS-matched cohort (195 ERIC patients, 630 SR patients) and the inverse probability of treatment weighting PS-adjusted cohort (206 ERIC patients, 1024 SR patients) there was no difference in terms of successful recanalization (modified TICI score ≥2b), good clinical outcome (mRS=0–2 or equal to pre-stroke mRS), or mortality at 3 months. Patients treated with first-line ERIC had a higher rate of complete recanalization (mTICI 3); however, they also required more passes and more frequent rescue therapy than the SR patient group.

    Conclusion In a large multicenter registry with PS matching, the ERIC device provided equivalent angiographic and clinical results to conventional SRs.

    Clinical trial registration URL: http://www.clinicaltrials.gov Unique identifier: NCT03776877.

    • stroke
    • thrombectomy

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    Footnotes

    • Collaborators Collaborators of ETIS (Endovascular Treatment in Ischemic Stroke): Michel Piotin, Raphael Blanc, Hocine Redjem, Simon Escalard, Jean-Philippe Desilles, Gabriele Ciccio, Stanislas Smajda, Benjamin Maier, Solene Hebert, François Delvoye, Mikael Mazighi, Mickael Obadia, Candice Sabben, Roxanne Peres, Ovide Corabianu, Thomas de Broucker, Didier Smadja, Sonia Alamowitch, Olivier Ille, Eric Manchon, Pierre-Yves Garcia, Guillaume Taylor, Malek Ben Maacha, Adrien Wang, Serge Evrard, Maya Tchikviladze, Nadia Ajili, Bertrand Lapergue, David Weisenburger, Lucas Gorza, Géraldine Buard, Oguzhan Coskun, Arturo Consoli, Federico Di Maria, Georges Rodesh, Sergio Zimatore, Morgan Leguen, Julie Gratieux, Fernando Pico, Haja Rakotoharinandrasana, Philippe Tassan, Roxanna Poll, Sylvie Marinier, Gaultier Marnat, Florent Gariel, Xavier Barreau, Jérôme Berge, Louis Veunac, Patrice Menegon, Igor Sibon, Ludovic Lucas, Stéphane Olindo, Pauline Renou, Sharmila Sagnier, Mathilde Poli, Sabrina Debruxelles, Romain Bourcier, Lili Detraz, Benjamin Daumas-Duport, Pierre-Louis Alexandre, Monica Roy, Cédric Lenoble, Vincent L’allinec, Jean-Baptiste Girot, Hubert Desal, Benjamin Gory, Serge Bracard, René Anxionnat, Marc Braun, Anne-Laure Derelle, Romain Tonnelet, Liang Liao, François Zhu, Emmanuelle Schmitt, Sophie Planel, Sébastien Richard, Lisa Humbertjean, Gioia Mione, Jean-Christophe Lacour, Mathieu Bonnerot, Nolwenn Riou-Comte, Vincent Costalat, Caroline Arquizan, Cyril Dargazanli, Grégory Gascou, Pierre-Henri Lefèvre, Imad Derraz, Carlos Riquelme, Nicolas Gaillard, Isabelle Mourand, Lucas Corti, Eugene Francois, Stéphane Vannier, Jean-christophe Ferre, Helene Raoult, Thomas Ronziere, Maria Lassale, Christophe Paya, Jean-Yves Gauvrit, Clément Tracol, Sophie Langnier-Lemercier.

    • Contributors Study design: CD, RB, JL, BL, RF. Acquisition, analysis, or interpretation of data: All authors. Drafting of the manuscript: CD, RB, JL, GW, BL, RF. Statistical analysis: JL. Supervision: BL, RF.

    • Funding This work was supported by a research grant from Microvention.

    • Competing interests BL received grants from Stryker, Microvention and Penumbra.

    • Patient consent for publication Not required.

    • Ethics approval The study received approval from the Fondation Rothschild Hospital’s ethics committee (research project ID=CE_20180504_3_RFD). According to the local regulating rules, patient consent is not required for this type of study with strictly anonymized data.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon reasonable request. Data, analytic methods, and study materials will be made available to any researcher for purposes of reproducing the results or replicating the procedure. Requests to receive these materials should be sent to the corresponding author, who will maintain their availability.

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