TREVO and Capture LP have equal technical success rates in mechanical thrombectomy of proximal and distal anterior circulation occlusions.
OBJECTIVE
Mechanical thrombectomy (MT) is a proven method to treat large vessel occlusions in acute anterior circulation stroke. We compared the technical, imaging, and clinical outcomes of MT performed with either TREVO or Capture LP devices.


METHODS
There were 42 and 43 patients in the TREVO and Capture LP groups, respectively. Baseline variables, technical outcome (Thrombolysis In Cerebral Infarction, TICI), 24 hours imaging outcome, and 3-month clinical outcome (modified Rankin Scale, mRS) were prospectively recorded. The patients were stratified according to clot location, groups compared, and logistic regression models devised to study the effect of device selection on the clinical outcome.


RESULTS
The technical success rates were equal in both proximal (internal carotid artery and proximal M1 segment) and distal occlusions (distal M1 and M2 segments). The proportion of TICI 2b or 3 was 96% and 87% with TREVO and 87% and 89% with Capture LP (p=0.25 and p=0.80, respectively). Device selection did not significantly predict good clinical outcome (mRS ≤2) in either proximal or distal occlusions. In multivariate analysis, selecting Capture LP borderline significantly increased the odds of an excellent outcome close to sixfold both in proximal and distal occlusions (OR 6.7, 95% CI 0.82 to 53.7, p=0.08 and OR 5.7, 95% CI 0.88 to 37.8, p=0.07, respectively).


CONCLUSIONS
TREVO and Capture LP perform equally well in proximal and distal occlusions in the anterior circulation when technical and good clinical outcome are considered. Capture LP may have a small advantage in reaching mRS ≤1 at 3 months. However, this needs to be confirmed in a randomized study.
Medical Imaging Center, Tampere University Hospital, Tampere, Finland.
Sara
S
Protto
Medical Imaging Center, Tampere University Hospital, Tampere, Finland.
Juha-Pekka
JP
Pienimäki
Medical Imaging Center, Tampere University Hospital, Tampere, Finland.
Janne
J
Seppänen
Medical Imaging Center, Tampere University Hospital, Tampere, Finland.
Ira
I
Matkaselkä
Department of Neurology, Tampere University Hospital, Tampere, Finland.
Jyrki
J
Ollikainen
Department of Neurology, Tampere University Hospital, Tampere, Finland.
Heikki
H
Numminen
Medical Imaging Center, Tampere University Hospital, Tampere, Finland.
Niko
N
Sillanpää
D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization / Q000295:instrumentation / Q000379:methods; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015607:Stents; D020521:Stroke / Q000000981:diagnostic imaging* / Q000601:surgery*; D017131:Thrombectomy / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome
Stroke; Thrombectomy