Stent Retriever for Acute Stroke: Post-market validation of revascularization and outcomes

CV
Source: 
Pubmed

The North American Solitaire Stent Retriever Acute Stroke (NASA) registry is the largest post-marketing study to date assessing radiographic and clinical outcomes of a stent retriever device, including 354 patients treated for acute ischemic stroke secondary to large vessel occlusion across 24 centersDespite differences between this trial and prior trials (SWIFT and TREVO 2) with respect to number of posterior circulation cases, mean time of onset to groin puncture time, and mean/median time to revascularization, there were no significant differences in 90 day mRS < 2 (42%), mortality (30.2%), or symptomatic ICH (9.9%).  Additionally, similar to SWIFT and TREVO 2, patients in NASA had excellent revascularization rates with 87.5% demonstrating TICI >2a.  The authors conclude that data from the previous, industry sponsored, randomized controlled stent retriever trials (SWIFT and TREVO 2) may be generalizable to real world practice.  Finally, these findings emphasize that these newer devices have favorable revascularization and clinical results.  This should be considered in light of the older generation devices utilized in the negative IMS-III, MR RESCUE and SYNTHESIS trials.

Michelle J. Smith, MD
Philadelphia, PA