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SNIS 21st annual meeting electronic poster abstracts
E-093 Trevo 3 mm and/or AXS catalyst 5 for the treatment of medium distal vessel occlusion stroke – a sub analysis of the assist registry
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  1. N Ntoulias1,
  2. A Brehm1,
  3. S Miralbés2,
  4. B Naravetla3,
  5. A Spiotta4,
  6. C Loehr5,
  7. M Martínez-Galdámez6,
  8. R McTaggart7,
  9. L Defreyne8,
  10. P Vega9,
  11. O Zaidat10,
  12. L Price11,
  13. D Liebeskind12,
  14. M Möhlenbruch13,
  15. R Gupta14,
  16. M Psychogios1
  1. 1Department of Diagnostic and Interventional Neuroradiology, University Hospital of Basel, Basel, Switzerland
  2. 2Department of Neuroradiology, Hospital Son Espases, Mallorca, Spain, Mallorca, Spain
  3. 3Interventional Neurology, McLaren Regional Medical Center, Flint and Macomb, Michigan, USA, Macomb and Flint, MI
  4. 4Neurosurgery, Medical University of South Carolina, Charleston, Charleston, SC
  5. 5Radiology and Neuroradiology, Klinikum Vest Recklinghausen, Recklinghausen, Germany
  6. 6Interventional Neuroradiology/Endovascular Neurosurgery, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
  7. 7Interventional Neuroradiology, Rhode Island Hospital, Rhode Island, RI
  8. 8Vascular and Interventional Radiology, Ghent University Hospital, Ghent, Belgium
  9. 9Radiology, Hospital Universitario Central de Asturias-HUCA, Oviedo, Spain
  10. 10Neuroscience Department, Bon Secours Mercy Health St. Vincent Medical Center, Toledo, OH
  11. 11Neurovascular, Stryker, Fremont, CA
  12. 12Department of Neurology and Comprehensive Stroke Center, David Geffen School of Medicine, University of California, Los Angeles, CA
  13. 13Neuroradiology, Uniklinik Heidelberg, Heidelberg, Germany
  14. 14Wellstar Medical Group, Neurosurgery, WellStar Health System, Marietta, GA

Abstract

Background The effect of endovascular therapy (EVT) on the outcome of stroke patients with a medium distal vessel occlusion (MDVO) is unclear. We report the results of MDVO patients treated with the 3 mm Trevo stent retriever (SR) and/or the AXS Catalyst 5 distal access catheter.

Methods Data was derived from a prospective, multicenter global registry which enrolled patients treated with operator preferred EVT technique at 71 hospitals from January 2019 to January 2022. Three techniques were assessed: SR classic, direct aspiration, and a primary combined approach. Additional inclusion criteria were (a) EVT performed with the 3 mm Trevo SR and/or AXS Catalyst 5 distal access catheter on the first pass and (b) an occlusion of the M2 segment or M3 segment of the middle cerebral artery or the A1, A2 or A3 segment of the anterior cerebral artery. The primary outcome was achieving an expanded Thrombolysis in Cerebral Infarction (eTICI) score of 2c or 3 on the first pass, with the primary technique as adjudicated by core lab. The primary clinical outcome measure was a 90-day modified Rankin Scale (mRS) score of 0–2.

Results A total of 155 patients (10.3% of the Registry population) were included. Most patients had an M2 occlusion (93.5%). First pass eTICI reperfusion was achieved in 43.1% of the patients. No modifying effect of the frontline technique was found. The rate of mRS 0 – 2 (overall 65%) did also not differ between groups.

Conclusion The data suggests that the Trevo 3 mm SR and/or the AXS Catalyst 5 are safe and effective devices for performing EVT of M2 occlusions. Further improvements are needed regarding materials and techniques to improve reperfusion results in this patient cohort in the future.

Disclosures N. Ntoulias: None. A. Brehm: None. S. Miralbés: None. B. Naravetla: None. A. Spiotta: 1; C; Penumbra, Stryker, Medtronic, Avail, Rapid AI, Brain Aneurysm Foundation. 2; C; Penumbra, Stryker, Terumo, RAPID AI, DSMB Brain Aneurysm Foundation. 4; C; Stock options for Avail. C. Loehr: 2; C; Penumbra, Phenox, Stryker. M. Martínez-Galdámez: None. R. McTaggart: None. L. Defreyne: 2; C; Cerenovus, Genentech, Medtronic, Rapid Medical, Stryker, and Vesalio. P. Vega: None. O. Zaidat: None. L. Price: 4; C; Stryker. 5; C; Stryker. D. Liebeskind: 2; C; for Cerenovus, Genentech, Medtronic, Rapid Medical, Stryker, and Vesalio. M. Möhlenbruch: 1; C; Acandis, Balt, Medtronic, Microvention, Phenox, Stryker. 3; C; Balt, Medtronic, Stryker. R. Gupta: 2; C; Vesalio, Rapid Medical. 4; C; Vesalio, Rapid Medical. 6; C; erves as Principal Investigator (PI) for the ASSIST Registry (Stryker), PI for the RECCLAIM II Study (Zoll), Clinical Events Committee (CEC) for the MIND Trial (Penumbra), Data Safety Monitoring Board. M. Psychogios: 1; C; Grant from Bangerter-Rhyner Stiftung, unrestrictedGrants from the Swiss National Scienc Grants from Stryker Neurovascular Inc., Phenox GmbH, Penumbra Inc. and Rapid Medical Inc for the DISTAL-Trial., Grants from the Swiss National Science Foundation (SNF) for the DISTAL trial (33IC30_198783), ICARUS (32003B_220118) and TECNO trial (32003B_204977). 3; C; Stryker Neurovascular Inc., Medtronic Inc., Penumbra Inc., Acandis GmbH, Phenox GmbH, Siemens Healthineers AG. 6; C; Research agreement with Siemens Healthineers AG, Local PI ACT in STROKE, ASSIST, EXCELLENT, TENSION, COATING, SELECT-2, SURF and ESCAPE-NEXT trials.

https://doi.org/10.1136/jnis-2024-SNIS.198

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