title: Single-center experience of cerebral artery thrombectomy using the TREVO device in 60 patients with acute ischemic stroke.
abstract: OBJECTIVE
  We sought to explore the safety and efficacy of the new TREVO stent-like retriever in consecutive patients with acute stroke.
  
  
  METHODS
  We conducted a prospective, single-center study of 60 patients (mean age, 71.3 years; male 47%) with stroke lasting <8 hours in the anterior circulation (n=54) or <12 hours in the vertebrobasilar circulation (n=6) treated if CT perfusion/CT angiography confirmed a large artery occlusion, ruled out a malignant profile, or showed target mismatch if symptoms >4.5 hours. Successful recanalization (Thrombolysis In Cerebral Infarction 2b-3), good outcome (modified Rankin Scale score 0-2) and mortality at Day 90, device-related complications, and symptomatic hemorrhage (parenchymal hematoma Type 1 or parenchymal hematoma Type 2 and National Institutes of Health Stroke Scale score increment ≥ 4 points) were prospectively assessed.
  
  
  RESULTS
  Median (interquartile range) National Institutes of Health Stroke Scale score on admission was 18 (12-22). The median (interquartile range) time from stroke onset to groin puncture was 210 (173-296) minutes. Successful revascularization was obtained in 44 (73.3%) of the cases when only the TREVO device was used and in 52 (86.7%) when other devices or additional intra-arterial tissue-type plasminogen activator were also required. The median time (interquartile range) of the procedure was 80 (45-114) minutes. Good outcome was achieved in 27 (45%) of the patients and the mortality rate was 28.3%. Seven patients (11.7%) presented a symptomatic intracranial hemorrhage. No other major complications were detected.
  
  
  CONCLUSIONS
  The TREVO device was reasonably safe and effective in patients with severe stroke. These results support further investigation of the TREVO device in multicentric registries and randomized clinical trials.
authors.affiliation: Functional Unit of Cerebrovascular Diseases, Hospital Clínic of Barcelona, Barcelona, Spain. lroman1@clinic.ub.es
authors.forename: Luis
authors.initials: L
authors.lastname: San Román
authors.forename: Victor
authors.initials: V
authors.lastname: Obach
authors.forename: Jordi
authors.initials: J
authors.lastname: Blasco
authors.forename: Juan
authors.initials: J
authors.lastname: Macho
authors.forename: Antonio
authors.initials: A
authors.lastname: Lopez
authors.forename: Xabier
authors.initials: X
authors.lastname: Urra
authors.forename: Alejandro
authors.initials: A
authors.lastname: Tomasello
authors.forename: Alvaro
authors.initials: A
authors.lastname: Cervera
authors.forename: Sergio
authors.initials: S
authors.lastname: Amaro
authors.forename: Joan
authors.initials: J
authors.lastname: Perandreu
authors.forename: Jordi
authors.initials: J
authors.lastname: Branera
authors.forename: Sebastián
authors.initials: S
authors.lastname: Capurro
authors.forename: Laura
authors.initials: L
authors.lastname: Oleaga
authors.forename: Angel
authors.initials: A
authors.lastname: Chamorro
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000628:therapy*; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000628:therapy*; D008297:Male; D061185:Mechanical Thrombolysis / Q000295:instrumentation* / Q000379:methods*; D008875:Middle Aged; D011446:Prospective Studies; D020521:Stroke / Q000628:therapy*