Japan Trevo Registry: Real-world Registry of Stent Retriever Alone or in Combined Therapy with Aspiration Catheter for Acute Ischemic Stroke in Japan
Endovascular therapy (EVT) for real-world patients after extended time frames is associated with concerns about its efficacy and safety. We conducted a prospective registry at 77 centers between November 2019 and October 2020. The registry criteria included patients treated with Trevo Retriever alon...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
The Japan Neurosurgical Society
2023-11-01
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| Series: | Neurologia Medico-Chirurgica |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/nmc/63/11/63_2023-0069/_pdf/-char/en |
| _version_ | 1797387903779733504 |
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| author | Kazutaka UCHIDA Nobuyuki SAKAI Hiroshi YAMAGAMI Kohei UEMURA Hirotoshi IMAMURA Masataka TAKEUCHI Manabu SHIRAKAWA Fumihiro SAKAKIBARA Koichi HARAGUCHI Naoto KIMURA Kentaro SUZUKI Junichi AYABE Daisuke YAMAMOTO Seigo SHINDO Atsushi KIMOTO Kenichi MORITA Yoshinori AKIYAMA Hidesato TAKEZAWA Shingo TOYOTA Kanta TANAKA Shigen KASAKURA Eisuke TSUKAGOSHI Toshihiro UEDA Shinichi YOSHIMURA Japan Trevo Registry Investigators |
| author_facet | Kazutaka UCHIDA Nobuyuki SAKAI Hiroshi YAMAGAMI Kohei UEMURA Hirotoshi IMAMURA Masataka TAKEUCHI Manabu SHIRAKAWA Fumihiro SAKAKIBARA Koichi HARAGUCHI Naoto KIMURA Kentaro SUZUKI Junichi AYABE Daisuke YAMAMOTO Seigo SHINDO Atsushi KIMOTO Kenichi MORITA Yoshinori AKIYAMA Hidesato TAKEZAWA Shingo TOYOTA Kanta TANAKA Shigen KASAKURA Eisuke TSUKAGOSHI Toshihiro UEDA Shinichi YOSHIMURA Japan Trevo Registry Investigators |
| author_sort | Kazutaka UCHIDA |
| collection | DOAJ |
| description | Endovascular therapy (EVT) for real-world patients after extended time frames is associated with concerns about its efficacy and safety. We conducted a prospective registry at 77 centers between November 2019 and October 2020. The registry criteria included patients treated with Trevo Retriever alone or in combined therapy with an aspiration catheter. The primary outcome was effective reperfusion (thrombolysis in cerebral infarction grade 2b), the secondary outcome was a modified Rankin scale 0-2 at 90 days, and the safety outcomes were worsening of neurologic symptoms within 24 h postoperatively, intracranial hemorrhage (ICH) within 24 h after EVT and mortality. We also exlpored the difference between patients whose last known well time (LKWT) to a puncture was less than 6 h (0-6 h) and those whose LKWT was 6 h or more but less than 24 h (6-24 h). Among the 1041 patients registered, 1025 patients were analyzed. The mean age was 76.9 years, and 53.6% of the participants were males. The 6-24 h group was 206/998 (20.6%), the median National Institute of Health Stroke Scale (NIHSS) score at admission was 18, and the median Alberta Stroke Program Early CT score was 8. Combined technique as the first pass was used on 817 (79.7%) patients. The primary outcome was 934 (91.1%). The secondary outcome was 433/1021 (42.4%). Symptomatic ICH, any ICH, and mortality were 10/1019 (1.0%), 311/1019 (30.5%), and 75 (7.3%). In the subanalysis, the 6-24 h group was lower in NIHSS (median;18 vs 16), and the secondary outcome was not significantly different in the <6 h group. Even after treatment time expansion, this result was comparable to other Trevo-based trials and nationwide registries. |
| first_indexed | 2024-03-08T22:32:57Z |
| format | Article |
| id | doaj.art-f78de34a2937465983b74792e408ab2e |
| institution | Directory Open Access Journal |
| issn | 1349-8029 |
| language | English |
| last_indexed | 2024-03-08T22:32:57Z |
| publishDate | 2023-11-01 |
| publisher | The Japan Neurosurgical Society |
| record_format | Article |
| series | Neurologia Medico-Chirurgica |
| spelling | doaj.art-f78de34a2937465983b74792e408ab2e2023-12-18T00:32:42ZengThe Japan Neurosurgical SocietyNeurologia Medico-Chirurgica1349-80292023-11-01631150351110.2176/jns-nmc.2023-00692023-0069Japan Trevo Registry: Real-world Registry of Stent Retriever Alone or in Combined Therapy with Aspiration Catheter for Acute Ischemic Stroke in JapanKazutaka UCHIDA0Nobuyuki SAKAI1Hiroshi YAMAGAMI2Kohei UEMURA3Hirotoshi IMAMURA4Masataka TAKEUCHI5Manabu SHIRAKAWA6Fumihiro SAKAKIBARA7Koichi HARAGUCHI8Naoto KIMURA9Kentaro SUZUKI10Junichi AYABE11Daisuke YAMAMOTO12Seigo SHINDO13Atsushi KIMOTO14Kenichi MORITA15Yoshinori AKIYAMA16Hidesato TAKEZAWA17Shingo TOYOTA18Kanta TANAKA19Shigen KASAKURA20Eisuke TSUKAGOSHI21Toshihiro UEDA22Shinichi YOSHIMURA23Japan Trevo Registry InvestigatorsDepartment of Neurosurgery, Hyogo Medical UniversityDepartment of Neurovascular Research, Kobe City Medical Center General HospitalDepartment of Stroke Neurology, National Hospital Organization Osaka National HospitalDepartment of Biostatistics and Bioinformatics, Interfaculty Initiative in Information Studies, The University of TokyoDepartment of Neurovascular Research, Kobe City Medical Center General HospitalDepartment of Neurosurgery, Seishou HospitalDepartment of Neurosurgery, Hyogo Medical UniversityDepartment of Neurosurgery, Hyogo Medical UniversityDepartment of Neurosurgery, Hakodate Shintoshi HospitalDepartment of Neurosurgery, Iwate Prefectural Central HospitalDepartment of Neurology, Nippon Medical SchoolDepartment of Neurosurgery, Yokosuka Kyosai HospitalDepartment of Neurosurgery, Kitasato University School of MedicineDepartment of Neurology, Japanese Red Cross Kumamoto HospitalDepartment of Neurosurgery, Tominaga HospitalDepartment of Cerebrovascular Medicine, Niigata City General HospitalDepartment of Neurosurgery, Tenri HospitalDepartment of Neuroendovascular Therapy and Neurology, Saiseikai Shiga HospitalDepartment of Neurosurgery, Kansai Rosai HospitalDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular CenterDepartment of Endovascular Neurosurgery, Saitama Medical University International Medical CenterDepartment of Endovascular Neurosurgery, Saitama Medical University International Medical CenterDepartment of Strokology and Neuroendovascular Treatment, Stroke Center, St. Marianna University Toyoko HospitalDepartment of Neurosurgery, Hyogo Medical UniversityEndovascular therapy (EVT) for real-world patients after extended time frames is associated with concerns about its efficacy and safety. We conducted a prospective registry at 77 centers between November 2019 and October 2020. The registry criteria included patients treated with Trevo Retriever alone or in combined therapy with an aspiration catheter. The primary outcome was effective reperfusion (thrombolysis in cerebral infarction grade 2b), the secondary outcome was a modified Rankin scale 0-2 at 90 days, and the safety outcomes were worsening of neurologic symptoms within 24 h postoperatively, intracranial hemorrhage (ICH) within 24 h after EVT and mortality. We also exlpored the difference between patients whose last known well time (LKWT) to a puncture was less than 6 h (0-6 h) and those whose LKWT was 6 h or more but less than 24 h (6-24 h). Among the 1041 patients registered, 1025 patients were analyzed. The mean age was 76.9 years, and 53.6% of the participants were males. The 6-24 h group was 206/998 (20.6%), the median National Institute of Health Stroke Scale (NIHSS) score at admission was 18, and the median Alberta Stroke Program Early CT score was 8. Combined technique as the first pass was used on 817 (79.7%) patients. The primary outcome was 934 (91.1%). The secondary outcome was 433/1021 (42.4%). Symptomatic ICH, any ICH, and mortality were 10/1019 (1.0%), 311/1019 (30.5%), and 75 (7.3%). In the subanalysis, the 6-24 h group was lower in NIHSS (median;18 vs 16), and the secondary outcome was not significantly different in the <6 h group. Even after treatment time expansion, this result was comparable to other Trevo-based trials and nationwide registries.https://www.jstage.jst.go.jp/article/nmc/63/11/63_2023-0069/_pdf/-char/enlarge vessel occlusiontrevo retrieverintracranial hemorrhageendovascular therapy |
| spellingShingle | Kazutaka UCHIDA Nobuyuki SAKAI Hiroshi YAMAGAMI Kohei UEMURA Hirotoshi IMAMURA Masataka TAKEUCHI Manabu SHIRAKAWA Fumihiro SAKAKIBARA Koichi HARAGUCHI Naoto KIMURA Kentaro SUZUKI Junichi AYABE Daisuke YAMAMOTO Seigo SHINDO Atsushi KIMOTO Kenichi MORITA Yoshinori AKIYAMA Hidesato TAKEZAWA Shingo TOYOTA Kanta TANAKA Shigen KASAKURA Eisuke TSUKAGOSHI Toshihiro UEDA Shinichi YOSHIMURA Japan Trevo Registry Investigators Japan Trevo Registry: Real-world Registry of Stent Retriever Alone or in Combined Therapy with Aspiration Catheter for Acute Ischemic Stroke in Japan Neurologia Medico-Chirurgica large vessel occlusion trevo retriever intracranial hemorrhage endovascular therapy |
| title | Japan Trevo Registry: Real-world Registry of Stent Retriever Alone or in Combined Therapy with Aspiration Catheter for Acute Ischemic Stroke in Japan |
| title_full | Japan Trevo Registry: Real-world Registry of Stent Retriever Alone or in Combined Therapy with Aspiration Catheter for Acute Ischemic Stroke in Japan |
| title_fullStr | Japan Trevo Registry: Real-world Registry of Stent Retriever Alone or in Combined Therapy with Aspiration Catheter for Acute Ischemic Stroke in Japan |
| title_full_unstemmed | Japan Trevo Registry: Real-world Registry of Stent Retriever Alone or in Combined Therapy with Aspiration Catheter for Acute Ischemic Stroke in Japan |
| title_short | Japan Trevo Registry: Real-world Registry of Stent Retriever Alone or in Combined Therapy with Aspiration Catheter for Acute Ischemic Stroke in Japan |
| title_sort | japan trevo registry real world registry of stent retriever alone or in combined therapy with aspiration catheter for acute ischemic stroke in japan |
| topic | large vessel occlusion trevo retriever intracranial hemorrhage endovascular therapy |
| url | https://www.jstage.jst.go.jp/article/nmc/63/11/63_2023-0069/_pdf/-char/en |
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