Faculty, Staff and Student Publications
Publication Date
5-21-2025
Journal
Interventional Neuroradiology
Abstract
BackgroundEndovascular therapy (EVT) for stroke due to distal or medium vessel occlusion (DMVO) is safe. Due to the distinct anatomical characteristics of DMVOs, further evaluation of EVT is crucial to determine which devices may yield better outcomes.MethodsA retrospective analysis of adults with DMVO treated in 37 centers (11 countries) was queried. The primary outcome of favorable shift in 90-day modified Rankin Scale (mRS) was compared between patients treated with Trevo versus other devices on first pass using 1:1 propensity score matching (PSM) with multivariable adjustment. Secondary outcomes included the number of pass attempts, final thrombolysis in cerebral infarction (TICI) score 2b-3, symptomatic intracranial hemorrhage (sICH), improvement in National Institutes of Health Stroke Scale (NIHSS) at 24h, and 90-day mortality.ResultsOf the 1115 included patients, 264 (24%) were treated with Trevo (PSM cohort of 261 per group). Trevo use was not associated with a favorable 90-day mRS shift (proportional odds ratio [OR] 1.10, 95% confidence interval [CI] 0.80-1.51). Trevo was associated with fewer passes (adjusted β=-0.25, 95% CI -0.48 - -0.03), higher odds of TICI 2b-3 (adjusted OR 1.97, 95% CI 1.11-3.49), and a greater 24h NIHSS improvement (adjusted β= -1.74, 95% CI -3.11 - -0.36), with no difference in sICH or mortality (p>0.05). Results were similar in sensitivity analyses.ConclusionsWe observed no safety concerns with Trevo as compared to other EVT devices for DMVO recanalization. There was a signal of better technical efficacy and early clinical improvement.
Keywords
Endovascular thrombectomy, Trevo stent-retriever, medium vessel occlusion, distal vessel occlusion, acute ischemic stroke
DOI
10.1177/15910199251341603
PMID
40398470
PMCID
PMC12095220
PubMedCentral® Posted Date
5-21-2025
PubMedCentral® Full Text Version
Post-print
Published Open-Access
yes