Comparison of Stent-Retriever Devices versus the Merci Retriever for Endovascular Treatment of Acute Stroke
Open Access
- 12 July 2012
- journal article
- clinical trial
- Published by American Society of Neuroradiology (ASNR) in American Journal of Neuroradiology
- Vol. 34 (2), 366-372
- https://doi.org/10.3174/ajnr.a3195
Abstract
BACKGROUND AND PURPOSE: Revascularization of large cerebral artery occlusion is the therapeutic goal in stroke therapy. Currently, many recanalization devices are in clinical use. This study compares the outcome parameters, efficacy, and safety of the new generation of stent-retriever devices with the well-established Merci retriever. MATERIALS AND METHODS: All patients who received endovascular mechanical recanalization therapy were prospectively registered. One hundred twenty-two patients were treated with either new stent retrievers, including the Trevo and Solitaire devices, or the Merci retriever system. Recanalization of the occluded vessel was assessed in accordance with the modified TICI score, and outcome parameters, including the NIHSS and mRS scores, were documented. Clinical status was recorded after neurointervention, at time of discharge, and after 90 days. RESULTS: The mean age of all patients was 68 years; 54% were male, with no statistical differences in demographics between both groups. Successful recanalization (TICI 3 and TICI 2b) was achieved in 82% of patients treated with stent retrievers compared with 62% of patients treated with Merci retrievers (P = .016). In the 90-day follow-up, 65% of patients treated with stent retrievers and 35% of those treated with the Merci had achieved a good (mRS = 0–2) clinical outcome (P = .002). Patients treated with stent retrievers had a significantly shorter treatment time (72 versus 122 minutes, P < .01) and less severe intracerebral hemorrhages (10% versus 28%, P < .01). CONCLUSIONS: Patients treated with Trevo and Solitaire stents had a better revascularization rate, better clinical outcome, and lower complication rate than patients treated with the Merci retriever.Keywords
This publication has 32 references indexed in Scilit:
- Mechanical Thrombectomy with a Self-Expanding Retrievable Intracranial Stent (Solitaire AB): Experience in 26 Patients with Acute Cerebral Artery Occlusion: Fig 1.American Journal of Neuroradiology, 2011
- Low-Dose Intra-Arterial Urokinase and Aggressive Mechanical Clot Disruption for Acute Ischemic Stroke after Failure of Intravenous ThrombolysisAmerican Journal of Neuroradiology, 2009
- Comparison of Mechanical Embolectomy and Intraarterial Thrombolysis in Acute Ischemic Stroke within the MCA: MERCI and Multi MERCI compared to PROACT IINeurocritical Care, 2008
- Thrombolysis with Alteplase 3 to 4.5 Hours after Acute Ischemic StrokeNew England Journal of Medicine, 2008
- Revascularization Results in the Interventional Management of Stroke II TrialAmerican Journal Of Neuroradiology, 2008
- Mechanical Thrombectomy of Intracranial Internal Carotid OcclusionStroke, 2007
- Safety and Efficacy of Mechanical Embolectomy in Acute Ischemic StrokeStroke, 2005
- Acute stenting and thromboaspiration in basilar artery occlusions due to embolism from the dominating vertebral arteryNeuroradiology, 2004
- Association of outcome with early stroke treatment: pooled analysis of ATLANTIS, ECASS, and NINDS rt-PA stroke trialsThe Lancet, 2004
- Aggressive Mechanical Clot Disruption and Low-dose Intra-arterial Third-generation Thrombolytic Agent for Ischemic Stroke: A Prospective StudyNeurosurgery, 2002