Endovascular therapy in the distal neurovascular territory: results of a large prospective registry.
BACKGROUND: There is a paucity of data regarding mechanical thrombectomy (MT) in distal arterial occlusions (DAO). We aim to evaluate the safety and efficacy of MT in patients with DAO and compare their outcomes with proximal arterial occlusion (PAO) strokes.
METHODS: The Trevo Registry was a prospective open-label MT registry including 2008 patients from 76 sites across 12 countries. Patients were categorized into: PAO: intracranial ICA, and MCA-M1; and DAO: MCA-M2, MCA-M3, ACA, and PCA. Baseline and outcome variables were compared across the PAO vs DAO patients with pre-morbid mRS 0-2.
RESULTS: Among 407 DAOs including 350 (86.0%) M2, 25 (6.1%) M3, 10 (2.5%) ACA, and 22 (5.4%) PCA occlusions, there were 376 DAO with pre-morbid mRS 0-2 which were compared with 1268 PAO patients. The median baseline NIHSS score was lower in DAO (13 [8-18] vs 16 [12-20], P
CONCLUSION: Endovascular therapy in DAO appears to result in a comparable safety and technical success profile as in PAO. The potential benefits of DAO thrombectomy should be investigated in future randomized trials.
Published In/Presented At
Nogueira, R. G., Mohammaden, M. H., Haussen, D. C., Budzik, R. F., Gupta, R., Krajina, A., English, J. D., Malek, A. R., Sarraj, A., Narata, A. P., Taqi, M. A., Frankel, M. R., Miller, T. R., Grobelny, T., Baxter, B. W., Bartolini, B. M., Jenkins, P., Estrade, L., Liebeskind, D., Veznedaroglu, E., … Trevo Registry Investigators (2021). Endovascular therapy in the distal neurovascular territory: results of a large prospective registry. Journal of neurointerventional surgery, 13(11), 979–984. https://doi.org/10.1136/neurintsurg-2020-016851
Diagnosis | Medicine and Health Sciences | Other Analytical, Diagnostic and Therapeutic Techniques and Equipment | Radiology
Department of Radiology and Diagnostic Medical Imaging