@article {Zaidat516, author = {Osama O Zaidat and Alicia C Castonguay and Raul G Nogueira and Diogo C Haussen and Joey D English and Sudhakar R Satti and Jennifer Chen and Hamed Farid and Candace Borders and Erol Veznedaroglu and Mandy J Binning and Ajit Puri and Nirav A Vora and Ron F Budzik and Guilherme Dabus and Italo Linfante and Vallabh Janardhan and Amer Alshekhlee and Michael G Abraham and Randall Edgell and Muhammad Asif Taqi and Ramy El Khoury and Maxim Mokin and Aniel Q Majjhoo and Mouhammed R Kabbani and Michael T Froehler and Ira Finch and Sameer A Ansari and Roberta Novakovic and Thanh N Nguyen}, title = {TREVO stent-retriever mechanical thrombectomy for acute ischemic stroke secondary to large vessel occlusion registry}, volume = {10}, number = {6}, pages = {516--524}, year = {2018}, doi = {10.1136/neurintsurg-2017-013328}, publisher = {British Medical Journal Publishing Group}, abstract = {Background Recent randomized clinical trials (RCTs) demonstrated the efficacy of mechanical thrombectomy using stent-retrievers in patients with acute ischemic stroke (AIS) with large vessel occlusions; however, it remains unclear if these results translate to a real-world setting. The TREVO Stent-Retriever Acute Stroke (TRACK) multicenter Registry aimed to evaluate the use of the Trevo device in everyday clinical practice.Methods Twenty-three centers enrolled consecutive AIS patients treated from March 2013 through August 2015 with the Trevo device. The primary outcome was defined as achieving a Thrombolysis in Cerebral Infarction (TICI) score of >=2b. Secondary outcomes included 90-day modified Rankin Scale (mRS), mortality, and symptomatic intracranial hemorrhage (sICH).Results A total of 634patients were included. Mean age was 66.1{\textpm}14.8 years and mean baseline NIH Stroke Scale (NIHSS) score was 17.4{\textpm}6.7; 86.7\% had an anterior circulation occlusion. Mean time from symptom onset to puncture and time to revascularization were 363.1{\textpm}264.5 min and 78.8{\textpm}49.6 min, respectively. 80.3\% achieved TICI >=2b. 90-day mRS <=2 was achieved in 47.9\%, compared with 51.4\% when restricting the analysis to the anterior circulation and within 6 hours (similar to recent AHA/ASA guidelines), and 54.3\% for those who achieved complete revascularization. The 90-day mortality rate was 19.8\%. Independent predictors of clinical outcome included age, baseline NIHSS, use of balloon guide catheter, revascularization, and sICH.Conclusion The TRACK Registry results demonstrate the generalizability of the recent thrombectomy RCTs in real-world clinical practice. No differences in clinical and angiographic outcomes were shown between patients treated within the AHA/ASA guidelines and those treated outside the recommendations.}, issn = {1759-8478}, URL = {https://jnis.bmj.com/content/10/6/516}, eprint = {https://jnis.bmj.com/content/10/6/516.full.pdf}, journal = {Journal of NeuroInterventional Surgery} }