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Abstracts
Ischemic
2.3. Treatment
P151 Trevo 3 mm and/or AXS catalyst 5 for the treatment of medium distal vessel occlusion stroke – results from the ASSIST registry
Free
  1. Nikolaos Ntoulias1,
  2. Alex Brehm2,
  3. Salvador Miralbés3,
  4. Bharath Naravetla4,
  5. Alejandro Spiotta5,
  6. Christian Loehr6,
  7. Mario Martínez-Galdámez7,
  8. Ryan McTaggart8,
  9. Luc Defreyne9,
  10. Pedro Vega10,
  11. Osama O Zaidat11,
  12. Lori Lyn Price12,
  13. David S Liebeskind13,
  14. Markus Möhlenbruch14,
  15. Rishi Gupta15,
  16. Marios-Nikos Psychogios2
  1. 1University Hospital of Basel, Department of Diagnostic and Interventional Neuroradiology, Basel, Switzerland
  2. 2Diagnostic and Interventional Neuroradiology, University Hospital Basel, Basel, CH
  3. 3Neuroradiology, Hospital Son Espases, Mallorca, Spain
  4. 4Interventional Neurology, McLaren Regional Medical Center, Flint, Michigan, USA, Interventional Neurology, McLaren Regional Medical Center, Macomb, Michigan, USA
  5. 5Neurosurgery, Medical University of South Carolina, Charleston, SC, USA
  6. 6Radiology and Neuroradiology, Klinikum Vest Recklinghausen, Recklinghausen, Germany
  7. 7Interventional Neuroradiology/Endovascular Neurosurgery, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
  8. 8Interventional Neuroradiology, Rhode Island Hospital, Providence, Rhode Island, USA
  9. 9Vascular and Interventional Radiology, Ghent University Hospital, Ghent, Belgium
  10. 10Radiology, Hospital Universitario Central de Asturias-HUCA, Oviedo, Spain
  11. 11Neuroscience Department, Bon Secours Mercy Health St. Vincent Medical Center, Toledo, Ohio, USA
  12. 12Stryker Neurovascular, Fremont, California, USA
  13. 13Department of Neurology and Comprehensive Stroke Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
  14. 14Neuroradiology, Uniklinik Heidelberg, Heidelberg, Germany
  15. 15Wellstar Medical Group, Neurosurgery, WellStar Health System, Marietta, Georgia, USA

Abstract

Introduction The effect of endovascular therapy (EVT) on the outcome of medium distal vessel occlusions (MDVO) is unclear.

Aim of Study To report the results of MDVOs treated with the Trevo-3mm-Stent-Retriver(SR) and/or the AXS-Catalyst5 distal access catheter(DAC).

Methods Data was derived from a prospective, multicenter global registry (ASSIST registry) which enrolled patients treated with operator preferred EVT technique at 71 sites from January 2019 to January 2022. Three techniques were assessed: SR classic, direct aspiration, and a combined approach. Additional inclusion criteria were (a) EVT performed with the Trevo-3mm-SR and/or AXS Catalyst5 (DAC) on the first pass and (b) an occlusion of medium/distal vesels. The primary outcome was achieving an expanded Thrombolysis in Cerebral Infarction (eTICI) score of 2c/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 (10.4% of the ASSIST 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 65.0%) did not significantly differ between groups.

Conclusion The data suggests that the Trevo3mm SR and/or the AXS-Catalyst5 may be an option to treat MDVOs, but more data is needed to demonstrate safety and efficacy in this patient cohort. Further improvements are needed regarding materials and techniques to improve reperfusion results in this patient-group.

https://doi.org/10.1136/jnis-2024-ESMINT.187

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