title: Acute Recanalization of Thrombo-Embolic Ischemic Stroke with pREset (ARTESp): the impact of occlusion time on clinical outcome of directly admitted and transferred patients.
abstract: OBJECTIVE
  Acute Recanalization of Thrombo-Embolic Ischemic Stroke with pREset (ARTESp) is a prospective multicenter study assessing the efficacy and safety of the pREset stent retriever for the treatment of intracranial vessel occlusion. Determination of the effect of transfer status on clinical outcome was a secondary objective.
  
  
  METHODS
  Efficacy was measured by recanalization success (Thrombolysis in Cerebral Infarction score ≥2b) and favorable clinical outcome at 90 days (modified Rankin Scale 0-2). Intracranial hemorrhage (ICH) and death at 90 days were safety measures. The outcome of directly admitted (DAP) and transferred (TP) patients was investigated using multivariable regression models.
  
  
  RESULTS
  Four study centers included 100 patients (mean age 68.3 years, median National Institutes of Health Stroke Scale score 15). Recanalization success was achieved in 84.4% after a mean of 1.7 passes. ICH was detected in 14.0%, with 2.0% being symptomatic. At 90 days, 62.5% of the patients had a favorable outcome and 7.3% died. TP had longer occlusion times (289 vs 180 minutes, p<0.001) and a lower rate of favorable outcome (58.0% vs 78.4%, p=0.046) than DAP. Multivariable regression revealed occlusion time as the critical determinant (OR=0.963, 95% CI 0.931 to 0.997, p=0.032), whereas transfer status itself showed no significant association (OR=0.565, CI 0.133 to 2.393, p=0.438).
  
  
  CONCLUSIONS
  pREset proved to be safe and effective for the treatment of acute intracranial vessel occlusion. Increased occlusion time impaired clinical outcome in TP.
  
  
  BACKGROUND
  NCT02437409; Results.
authors.affiliation: Abteilung für Diagnostische und Interventionelle Neuroradiologie, Klinikum rechts der Isar, Technische Universität München, München, Germany.
authors.forename: Sascha
authors.identifier: http://orcid.org/0000-0002-3964-3885
authors.initials: S
authors.lastname: Prothmann
authors.affiliation: Abteilung für Diagnostische und Interventionelle Neuroradiologie, Klinikum rechts der Isar, Technische Universität München, München, Germany.
authors.forename: Benedikt J
authors.initials: BJ
authors.lastname: Schwaiger
authors.affiliation: Abteilung für Diagnostische und Interventionelle Neuroradiologie, Klinikum rechts der Isar, Technische Universität München, München, Germany.
authors.forename: Alexandra S
authors.initials: AS
authors.lastname: Gersing
authors.affiliation: Klinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Reith
authors.affiliation: Institut für Klinische Radiologie, Universitätsklinikum Münster, Münster, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Niederstadt
authors.affiliation: Institut für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Ev. Stift St. Martin, Gemeinschaftsklinikum Mittelrhein, Koblenz, Germany.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Felber
authors.affiliation: Neuroradiologische Klinik, Klinikum Stuttgart, Stuttgart, Germany.
authors.forename: Wiebke
authors.initials: W
authors.lastname: Kurre
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D061185:Mechanical Thrombolysis / Q000379:methods*; D008875:Middle Aged; D010343:Patient Admission / Q000639:trends*; D010360:Patient Transfer / Q000639:trends*; D011446:Prospective Studies; D015607:Stents; D020521:Stroke / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D013923:Thromboembolism / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Device; Stroke; Thrombectomy