Abstract Number ‐ 7: Final Angiographic, Clinical and Thrombus Composition Results of 1000 Patients in the EXCELLENT Registry
Introduction EXCELLENT (NCT03685578; Cerenovus) is a large, prospective, international, real‐world registry of endovascular clot removal in acute ischemic stroke (AIS) with EmboTrap as the first line mechanical thrombectomy (MT) device, which included collection and analysis of the retrieved thrombu...
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| Format: | Article |
| Language: | English |
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Wiley
2023-03-01
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| Series: | Stroke: Vascular and Interventional Neurology |
| Online Access: | https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_1.007 |
| _version_ | 1797803513362776064 |
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| author | Raul G Nogueira Tommy Andersson Albert J Yoo Ricardo A Hanel Osama O Zaidat Werner Hacke Tudor Jovin Jens Fiehler Simon F De Meyer Waleed Brinjikji Karen Doyle David S Liebeskind Diogo Haussen Violiza Inoa William Humphries Keith B Woodward Pascal M Jabbour Olivier Francois Hormozd Bozorgchami Elad I Levy Stephan Boor Jose Cohen Shervin R Dashti Muhammad A Taqi Ronald F Budzik Clemens M Schirmer Shazam Hussain Laurent Estrade Reade A De Leacy Ajit S Puri Rohan V Chitale Caspar Brekenfeld Adnan H Siddiqui |
| author_facet | Raul G Nogueira Tommy Andersson Albert J Yoo Ricardo A Hanel Osama O Zaidat Werner Hacke Tudor Jovin Jens Fiehler Simon F De Meyer Waleed Brinjikji Karen Doyle David S Liebeskind Diogo Haussen Violiza Inoa William Humphries Keith B Woodward Pascal M Jabbour Olivier Francois Hormozd Bozorgchami Elad I Levy Stephan Boor Jose Cohen Shervin R Dashti Muhammad A Taqi Ronald F Budzik Clemens M Schirmer Shazam Hussain Laurent Estrade Reade A De Leacy Ajit S Puri Rohan V Chitale Caspar Brekenfeld Adnan H Siddiqui |
| author_sort | Raul G Nogueira |
| collection | DOAJ |
| description | Introduction EXCELLENT (NCT03685578; Cerenovus) is a large, prospective, international, real‐world registry of endovascular clot removal in acute ischemic stroke (AIS) with EmboTrap as the first line mechanical thrombectomy (MT) device, which included collection and analysis of the retrieved thrombus material. Methods Between September 2018 and March 2021, 1000 “all‐comer” patients were enrolled at 34 global sites (27 US, 5 EU, 1 UK, 1 Israel) and treated according to standard of care at each center (with Embrotrap as first line). The study employed blind endpoint evaluation, including a core imaging lab and an independent 90‐day mRS assessment. Retrieved clot was collected per each MT maneuver from 538 subjects across 26 sites and clot analysis was performed by independent central labs blinded to clinical data. Results mITT population included 998 subjects. Mean age was 69.9±14.18 years (range 18–102), 51.8% (517/998) subjects were female and 9.9% (97/997) had a pre‐stroke mRS 3–5. Baseline NIHSS was 15.6±6.87 (range 0–36); 10.1% (82/815) subjects had a large core (ASPECTS 0–5); 5.8% (57/990) had posterior stroke; 56.3% (523/929) underwent MT ≤ 6hrs of onset and 38.1% (380/998) received IV‐tPA prior to MT. First pass eTICI 2c‐3 was achieved in 38.3% (377/984) and final 2b‐3 in 94.5 % (930/984; median number of passes = 1) of subjects. 90‐day mRS≤2 or ≤pre‐stroke was 46.9% (429/915) and 90‐day all‐cause mortality was 19.0% (175/921). The univariate analysis of clot components showed high red blood cell and low platelet content were significant predictors of good mRS outcome (p < 0.001 and 0.009) and negative predictors of 90‐day mortality (p < 0.001 and 0.017, respectively). Conclusions This large multi‐center, all‐comer cohort reflects the population undergoing thrombectomy today in a real world‐setting. Final angiographic, clinical and thrombus composition results, along with multivariate analysis of predictors of clinical outcomes, will be presented at the time of the conference. |
| first_indexed | 2024-03-13T05:22:00Z |
| format | Article |
| id | doaj.art-2cb47235f3234c919bc16afa3930f406 |
| institution | Directory Open Access Journal |
| issn | 2694-5746 |
| language | English |
| last_indexed | 2024-03-13T05:22:00Z |
| publishDate | 2023-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Stroke: Vascular and Interventional Neurology |
| spelling | doaj.art-2cb47235f3234c919bc16afa3930f4062023-06-15T10:40:49ZengWileyStroke: Vascular and Interventional Neurology2694-57462023-03-013S110.1161/SVIN.03.suppl_1.007Abstract Number ‐ 7: Final Angiographic, Clinical and Thrombus Composition Results of 1000 Patients in the EXCELLENT RegistryRaul G Nogueira0Tommy Andersson1Albert J Yoo2Ricardo A Hanel3Osama O Zaidat4Werner Hacke5Tudor Jovin6Jens Fiehler7Simon F De Meyer8Waleed Brinjikji9Karen Doyle10David S Liebeskind11Diogo Haussen12Violiza Inoa13William Humphries14Keith B Woodward15Pascal M Jabbour16Olivier Francois17Hormozd Bozorgchami18Elad I Levy19Stephan Boor20Jose Cohen21Shervin R Dashti22Muhammad A Taqi23Ronald F Budzik24Clemens M Schirmer25Shazam Hussain26Laurent Estrade27Reade A De Leacy28Ajit S Puri29Rohan V Chitale30Caspar Brekenfeld31Adnan H Siddiqui32UPMC Stroke Institute, University of Pittsburgh Medical Center Pittsburgh Pennsylvania United States of AmericaKarolinska University Hospital and Karolinska Institute Stockholm SwedenTexas Stroke Institute Plane Texas United States of AmericaBaptist Neurological Institute Jacksonville Florida United States of AmericaMercy St. Vincent Medical Center Toledo Ohio United States of AmericaUniversity of Heidelberg Heidelberg GermanyUniversity of Pittsburgh Medical Center Pittsburgh Pennsylvania United States of AmericaUniversity Medical Center Hamburg Eppendorf Hamburg GermanyKU Leuven Kortrijk BelgiumMayo Clinic Rochester Minnesota United States of AmericaNational University of Ireland Galway IrelandUniversity of California Los Angeles Los Angeles California United States of AmericaGrady Memorial Hospital Atlanta Georgia United States of AmericaUniversity of Tennessee Health Science Center Memphis Tennessee United States of AmericaWellstar Health System, Kennestone Hospital Marietta Georgia United States of AmericaFort Sanders Regional Medical Center Knoxville United States of AmericaThomas Jefferson University Hospital Philadelphia United States of AmericaAZ Groeninge Kortrjik BelgiumOregon Health and Sciences University Portland United States of AmericaUniversity at Buffalo, State University of New York Williamsville United States of AmericaUniversity Medical Center of the Johannes Gutenberg University Mainz Mainz GermanyHadassah University Medical Center Jerusalem IsraelNorton Neuroscience Institute Louisville United States of AmericaLos Robles Hospital and Medical Center Thousand Oaks United States of AmericaRiverside Methodist Hospital Columbus United States of AmericaGeisinger Health System Danville United States of AmericaCleveland Clinic Cleveland United States of AmericaLille University Hospital Lille FranceIcahn School of Medicine at Mount Sinai New York United States of AmericaUniversity of Massachusetts Worcester United States of AmericaVanderbilt University Medical Center Nashville United States of AmericaUniversity Medical Center Hamburg Hamburg GermanySUNY Buffalo Buffalo United States of AmericaIntroduction EXCELLENT (NCT03685578; Cerenovus) is a large, prospective, international, real‐world registry of endovascular clot removal in acute ischemic stroke (AIS) with EmboTrap as the first line mechanical thrombectomy (MT) device, which included collection and analysis of the retrieved thrombus material. Methods Between September 2018 and March 2021, 1000 “all‐comer” patients were enrolled at 34 global sites (27 US, 5 EU, 1 UK, 1 Israel) and treated according to standard of care at each center (with Embrotrap as first line). The study employed blind endpoint evaluation, including a core imaging lab and an independent 90‐day mRS assessment. Retrieved clot was collected per each MT maneuver from 538 subjects across 26 sites and clot analysis was performed by independent central labs blinded to clinical data. Results mITT population included 998 subjects. Mean age was 69.9±14.18 years (range 18–102), 51.8% (517/998) subjects were female and 9.9% (97/997) had a pre‐stroke mRS 3–5. Baseline NIHSS was 15.6±6.87 (range 0–36); 10.1% (82/815) subjects had a large core (ASPECTS 0–5); 5.8% (57/990) had posterior stroke; 56.3% (523/929) underwent MT ≤ 6hrs of onset and 38.1% (380/998) received IV‐tPA prior to MT. First pass eTICI 2c‐3 was achieved in 38.3% (377/984) and final 2b‐3 in 94.5 % (930/984; median number of passes = 1) of subjects. 90‐day mRS≤2 or ≤pre‐stroke was 46.9% (429/915) and 90‐day all‐cause mortality was 19.0% (175/921). The univariate analysis of clot components showed high red blood cell and low platelet content were significant predictors of good mRS outcome (p < 0.001 and 0.009) and negative predictors of 90‐day mortality (p < 0.001 and 0.017, respectively). Conclusions This large multi‐center, all‐comer cohort reflects the population undergoing thrombectomy today in a real world‐setting. Final angiographic, clinical and thrombus composition results, along with multivariate analysis of predictors of clinical outcomes, will be presented at the time of the conference.https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_1.007 |
| spellingShingle | Raul G Nogueira Tommy Andersson Albert J Yoo Ricardo A Hanel Osama O Zaidat Werner Hacke Tudor Jovin Jens Fiehler Simon F De Meyer Waleed Brinjikji Karen Doyle David S Liebeskind Diogo Haussen Violiza Inoa William Humphries Keith B Woodward Pascal M Jabbour Olivier Francois Hormozd Bozorgchami Elad I Levy Stephan Boor Jose Cohen Shervin R Dashti Muhammad A Taqi Ronald F Budzik Clemens M Schirmer Shazam Hussain Laurent Estrade Reade A De Leacy Ajit S Puri Rohan V Chitale Caspar Brekenfeld Adnan H Siddiqui Abstract Number ‐ 7: Final Angiographic, Clinical and Thrombus Composition Results of 1000 Patients in the EXCELLENT Registry Stroke: Vascular and Interventional Neurology |
| title | Abstract Number ‐ 7: Final Angiographic, Clinical and Thrombus Composition Results of 1000 Patients in the EXCELLENT Registry |
| title_full | Abstract Number ‐ 7: Final Angiographic, Clinical and Thrombus Composition Results of 1000 Patients in the EXCELLENT Registry |
| title_fullStr | Abstract Number ‐ 7: Final Angiographic, Clinical and Thrombus Composition Results of 1000 Patients in the EXCELLENT Registry |
| title_full_unstemmed | Abstract Number ‐ 7: Final Angiographic, Clinical and Thrombus Composition Results of 1000 Patients in the EXCELLENT Registry |
| title_short | Abstract Number ‐ 7: Final Angiographic, Clinical and Thrombus Composition Results of 1000 Patients in the EXCELLENT Registry |
| title_sort | abstract number 7 final angiographic clinical and thrombus composition results of 1000 patients in the excellent registry |
| url | https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_1.007 |
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