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Conference Paper: Aspiration versus stent-retriever first: a single center open-label randomized controlled trial on endovascular thrombectomy for acute large vessel occlusion stroke

TitleAspiration versus stent-retriever first: a single center open-label randomized controlled trial on endovascular thrombectomy for acute large vessel occlusion stroke
Authors
Issue Date2020
PublisherSage Publications Ltd. The Journal's web site is located at http://www.sagepub.in/journals/Journal202429
Citation
Joint European Stroke Organisation and World Stroke Organisation Conference (ESO-WSO 2020), Virtual Conference, 7-9 November 2020. In International Journal of Stroke, 2020, v. 15 n. 1, Suppl., p. 177 How to Cite?
AbstractBackground And Aims: There is ongoing debate regarding the optimal first-line technique for endovascular thrombectomy for acute ischemic stroke due to large vessel occlusion. We performed a randomized trial on aspiration-first versus stent-retriever-first thrombectomy in a single-center real-world setting serving an Asian (Hong Kong Chinese) population to compare their clinical efficacy, safety and cost-effectiveness. Methods: This is a single-center, prospective, open-label, randomized study comparing aspiration-first versus stent-retriever first thrombectomy. Eligible patients were randomized 1:1 to either aspiration-first or stent-retriever first, with rescue devices allowed after at least 2 failed attempts with the primary device. Patient recruitment began in October 2017 and was completed in September 2019. The primary outcome was mRS at 90 days, with secondary outcomes of TICI 2b/3 reperfusion rate, groin-to-perfusion time, procedural complications, total device cost, and mortality. Results: In total 58 patients were recruited (28 aspiration-first, 30 stent-retriever first) and were included in the final analysis. There were no significant differences in the demographics, stroke etiology and severity, and the use of IV thrombolytics between groups. Clinical outcomes between aspiration-first and stent-retriever first were comparable in terms of mRS 0–2 at 90 days (39.3% vs 33.3%, p = 0.42), TICI 2b/3 reperfusion (89.3% vs 86.7%, p = 1.00), groin-to-perfusion time (67 vs 88 minutes, p = 0.14) and mortality (10.7% vs 30%, p = 0.11). Aspiration-first approach was associated with less use of rescue strategy (28.6% vs 63.3%, p = 0.01) and a trend of lower total device cost (US$7,746 vs $9800, p = 0.06). Conclusions: Aspiration-first thrombectomy was non-inferior to stent-retriever first strategy and maybe more cost-efficient as a first-line thrombectomy technique in our population.
Description00634 / #2021 E-Poster Viewing - AS02. Clinical Trial Results – Acute Management – Thrombolysis or Thrombectomy
Persistent Identifierhttp://hdl.handle.net/10722/308111
ISSN
2023 Impact Factor: 6.3
2023 SCImago Journal Rankings: 1.800

 

DC FieldValueLanguage
dc.contributor.authorTsang, COA-
dc.contributor.authorTse, MYM-
dc.contributor.authorLee, R-
dc.contributor.authorTsang, FCP-
dc.contributor.authorHo, WS-
dc.contributor.authorLui, WM-
dc.date.accessioned2021-11-12T13:42:40Z-
dc.date.available2021-11-12T13:42:40Z-
dc.date.issued2020-
dc.identifier.citationJoint European Stroke Organisation and World Stroke Organisation Conference (ESO-WSO 2020), Virtual Conference, 7-9 November 2020. In International Journal of Stroke, 2020, v. 15 n. 1, Suppl., p. 177-
dc.identifier.issn1747-4930-
dc.identifier.urihttp://hdl.handle.net/10722/308111-
dc.description00634 / #2021 E-Poster Viewing - AS02. Clinical Trial Results – Acute Management – Thrombolysis or Thrombectomy-
dc.description.abstractBackground And Aims: There is ongoing debate regarding the optimal first-line technique for endovascular thrombectomy for acute ischemic stroke due to large vessel occlusion. We performed a randomized trial on aspiration-first versus stent-retriever-first thrombectomy in a single-center real-world setting serving an Asian (Hong Kong Chinese) population to compare their clinical efficacy, safety and cost-effectiveness. Methods: This is a single-center, prospective, open-label, randomized study comparing aspiration-first versus stent-retriever first thrombectomy. Eligible patients were randomized 1:1 to either aspiration-first or stent-retriever first, with rescue devices allowed after at least 2 failed attempts with the primary device. Patient recruitment began in October 2017 and was completed in September 2019. The primary outcome was mRS at 90 days, with secondary outcomes of TICI 2b/3 reperfusion rate, groin-to-perfusion time, procedural complications, total device cost, and mortality. Results: In total 58 patients were recruited (28 aspiration-first, 30 stent-retriever first) and were included in the final analysis. There were no significant differences in the demographics, stroke etiology and severity, and the use of IV thrombolytics between groups. Clinical outcomes between aspiration-first and stent-retriever first were comparable in terms of mRS 0–2 at 90 days (39.3% vs 33.3%, p = 0.42), TICI 2b/3 reperfusion (89.3% vs 86.7%, p = 1.00), groin-to-perfusion time (67 vs 88 minutes, p = 0.14) and mortality (10.7% vs 30%, p = 0.11). Aspiration-first approach was associated with less use of rescue strategy (28.6% vs 63.3%, p = 0.01) and a trend of lower total device cost (US$7,746 vs $9800, p = 0.06). Conclusions: Aspiration-first thrombectomy was non-inferior to stent-retriever first strategy and maybe more cost-efficient as a first-line thrombectomy technique in our population.-
dc.languageeng-
dc.publisherSage Publications Ltd. The Journal's web site is located at http://www.sagepub.in/journals/Journal202429-
dc.relation.ispartofInternational Journal of Stroke-
dc.relation.ispartofJoint European Stroke Organisation and World Stroke Organisation Conference (ESO-WSO 2020)-
dc.titleAspiration versus stent-retriever first: a single center open-label randomized controlled trial on endovascular thrombectomy for acute large vessel occlusion stroke-
dc.typeConference_Paper-
dc.identifier.emailTsang, COA: acotsang@hku.hk-
dc.identifier.emailHo, WS: owsw@hku.hk-
dc.identifier.authorityTsang, COA=rp01519-
dc.description.natureabstract-
dc.identifier.hkuros329412-
dc.identifier.volume15-
dc.identifier.issue1, Suppl.-
dc.identifier.spage177-
dc.identifier.epage177-
dc.publisher.placeUnited Kingdom-
dc.identifier.partofdoi10.1177/1747493020963387-

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