TY - JOUR T1 - TREVO stent-retriever mechanical thrombectomy for acute ischemic stroke secondary to large vessel occlusion registry JF - Journal of NeuroInterventional Surgery JO - J NeuroIntervent Surg SP - 516 LP - 524 DO - 10.1136/neurintsurg-2017-013328 VL - 10 IS - 6 AU - Osama O Zaidat AU - Alicia C Castonguay AU - Raul G Nogueira AU - Diogo C Haussen AU - Joey D English AU - Sudhakar R Satti AU - Jennifer Chen AU - Hamed Farid AU - Candace Borders AU - Erol Veznedaroglu AU - Mandy J Binning AU - Ajit Puri AU - Nirav A Vora AU - Ron F Budzik AU - Guilherme Dabus AU - Italo Linfante AU - Vallabh Janardhan AU - Amer Alshekhlee AU - Michael G Abraham AU - Randall Edgell AU - Muhammad Asif Taqi AU - Ramy El Khoury AU - Maxim Mokin AU - Aniel Q Majjhoo AU - Mouhammed R Kabbani AU - Michael T Froehler AU - Ira Finch AU - Sameer A Ansari AU - Roberta Novakovic AU - Thanh N Nguyen Y1 - 2018/06/01 UR - http://jnis.bmj.com/content/10/6/516.abstract N2 - 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±14.8 years and mean baseline NIH Stroke Scale (NIHSS) score was 17.4±6.7; 86.7% had an anterior circulation occlusion. Mean time from symptom onset to puncture and time to revascularization were 363.1±264.5 min and 78.8±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. ER -