First Pass Effect in Patients Treated With the Trevo Stent-Retriever: A TRACK Registry Study Analysis
Year: 2020
Type: article
Abstract: Background and Objective The first pass effect (FPE; achieving complete recanalization with a single thrombectomy device pass) has been shown to be associated with higher rates of good clinical outcomes in patients with acute ischemic stroke. Here, we investigate clinical and radiographic predictors of FPE in a large U.S. post-marketing registry (TRACK, Trevo Stent-Retriever Acute Stroke). Methods FPE was defined as a single pass/use of device, TICI 2c/3 recanalization, and no use of rescue therapy. Analysis of individual patient data from TRACK was performed to analyze clinical and radiographic predictors of FPE. Results 609 patients were included in analysis. The rate of FPE in TRACK was 23% (140/609). There was no association between patient demographics and FPE, including age (p=0.36), sex (p=0.50), race (p=0.50), location of occlusion (p=0.26), baseline NIHSS (p=0.62), or past medical history. There was no difference in the use of a balloon-guide catheter or general anesthesia (49% and 57% with FPE vs. 47% and 64%, p=0.63 and p=0.14, respectively). Clinical outcomes were significantly associated with FPE; 63% vs. 44% in non-FPE patients achieved mRS 0-2 at 90 days (p=0.0004). Conclusion Our study showed that achieving complete recanalization with a single thrombectomy pass using the Trevo device was highly beneficial. The most common clinical factors that are used to determine eligibility for endovascular therapy, such as NIHSS severity, location of occlusion or patient age were not predictive of the ability to achieve FPE.
Source: Frontiers in Neurology
Authors: Maxim Mokin, Christopher T. Primiani, Alicia C. Castonguay, Raul G. Nogueira, Diogo C. Haussen, Joey D. English, Sudhakar R. Satti, Jennifer Chen, Hamed Farid, Candace Borders, Erol Veznedaroglu, Mandy J. Binning, Ajit Puri, Nirav A. Vora, Ron F. Budzik, Guilherme Dabus, Italo Linfante, Vallabh Janardhan, Amer Alshekhlee, Michael G. Abraham, Randall Edgell, Muhammad Asif Taqi, Ramy El Khoury, Aniel Q. Majjhoo, Mouhammed R. Kabbani, Michael T. Froehler, Ira Finch, Sameer A. Ansari, Roberta Novakovic, Thanh N. Nguyen, Osama O. Zaidat
Institutions: University of South Florida, University of Toledo, Emory University, California Pacific Medical Center, Christiana Hospital, St. Jude Medical Center, University of California, Irvine, Drexel University, University of Massachusetts Chan Medical School, Baptist Hospital of Miami, University of Kansas Medical Center, Saint Louis University, Los Robles Hospital & Medical Center, Tulane University, Wayne State University, Gundersen Health System, Vanderbilt University Medical Center, John Muir Health, John Muir Medical Center, Northwestern University, The University of Texas Southwestern Medical Center, Boston Medical Center, Mercy St. Vincent Medical Center
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,950
OpenAlex ID: W3008650000