Safety and Efficacy of Solitaire Stent Thrombectomy

Supplemental Digital Content is available in the text. Patient-level data were pooled from trials in which the Solitaire was the only or the predominant device used in a prespecified meta-analysis (SEER Collaboration): Solitaire FR With the Intention for Thrombectomy as Primary Endovascular Treatmen...

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Autores: Campbell, Bruce C.V|||0000-0003-3632-9433, Hill, M. D|||0000-0002-6269-1543, Rubiera Del Fueyo, Marta A|||0000-0001-8100-9477, Menon, Bijoy K., Demchuk, Andrew, Donnan, Geoffrey A., Roy, Daniel, Thornton, John, Dorado Bouix, Laura|||0000-0003-1095-6797, Bonafe, Alain, Levy, Elad I., Diener, Hans-Christoph|||0000-0002-6556-8612, Hernández-Pérez, María|||0000-0001-8279-7954, Pereira, Vitor Mendes, Blasco, Jordi, Quesada, Helena|||0009-0009-1846-0447, Rempel, Jeremy, Jahan, Reza, Davis, Stephen M., Stouch, Bruce C., Mitchell, Peter J., Jovin, Tudor G.|||0000-0002-2619-6975, Saver, Jeffrey L.., Goyal, Mayank
Tipo de recurso: artículo
Fecha de publicación:2016
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:185801
Acceso en línea:https://ddd.uab.cat/record/185801
https://dx.doi.org/urn:doi:10.1161/STROKEAHA.115.012360
Access Level:acceso abierto
Palabra clave:Endovascular treatment
Intra-arterial therapy
Ischemic stroke
Mechanical thrombectomy
Meta-analysis
Randomized controlled trial
Stent retriever device
Thrombolysis
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spelling Safety and Efficacy of Solitaire Stent ThrombectomyCampbell, Bruce C.V|||0000-0003-3632-9433Hill, M. D|||0000-0002-6269-1543Rubiera Del Fueyo, Marta A|||0000-0001-8100-9477Menon, Bijoy K.Demchuk, AndrewDonnan, Geoffrey A.Roy, DanielThornton, JohnDorado Bouix, Laura|||0000-0003-1095-6797Bonafe, AlainLevy, Elad I.Diener, Hans-Christoph|||0000-0002-6556-8612Hernández-Pérez, María|||0000-0001-8279-7954Pereira, Vitor MendesBlasco, JordiQuesada, Helena|||0009-0009-1846-0447Rempel, JeremyJahan, RezaDavis, Stephen M.Stouch, Bruce C.Mitchell, Peter J.Jovin, Tudor G.|||0000-0002-2619-6975Saver, Jeffrey L..Goyal, MayankEndovascular treatmentIntra-arterial therapyIschemic strokeMechanical thrombectomyMeta-analysisRandomized controlled trialStent retriever deviceThrombolysisSupplemental Digital Content is available in the text. Patient-level data were pooled from trials in which the Solitaire was the only or the predominant device used in a prespecified meta-analysis (SEER Collaboration): Solitaire FR With the Intention for Thrombectomy as Primary Endovascular Treatment (SWIFT PRIME), Endovascular Treatment for Small Core and Anterior Circulation Proximal Occlusion With Emphasis on Minimizing CT to Recanalization Times (ESCAPE), Extending the Time for Thrombolysis in Emergency Neurological Deficits-Intra-Arterial (EXTEND-IA), and Randomized Trial of Revascularization With Solitaire FR Device Versus Best Medical Therapy in the Treatment of Acute Stroke Due to Anterior Circulation Large Vessel Occlusion Presenting Within Eight Hours of Symptom Onset (REVASCAT). The primary outcome was ordinal analysis of modified Rankin Score at 90 days. The primary analysis included all patients in the 4 trials with 2 sensitivity analyses: (1) excluding patients in whom Solitaire was not the first device used and (2) including the 3 Solitaire-only trials (excluding ESCAPE). Secondary outcomes included functional independence (modified Rankin Score 0-2), symptomatic intracerebral hemorrhage, and mortality. The primary analysis included 787 patients: 401 randomized to endovascular thrombectomy and 386 to standard care, and 82.6% received intravenous thrombolysis. The common odds ratio for modified Rankin Score improvement was 2.7 (2.0-3.5) with no heterogeneity in effect by age, sex, baseline stroke severity, extent of computed tomography changes, site of occlusion, or pretreatment with alteplase. The number needed to treat to reduce disability was 2.5 and for an extra patient to achieve independent outcome was 4.25 (3.29-5.99). Successful revascularization occurred in 77% treated with Solitaire device. The rate of symptomatic intracerebral hemorrhage and overall mortality did not differ between treatment groups. Solitaire thrombectomy for large vessel ischemic stroke was safe and highly effective with substantially reduced disability. Benefits were consistent in all prespecified subgroups.Universitat Autònoma de Barcelona 22016-01-0120162016-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/185801https://dx.doi.org/urn:doi:10.1161/STROKEAHA.115.012360reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:1858012026-06-06T12:50:31Z
dc.title.none.fl_str_mv Safety and Efficacy of Solitaire Stent Thrombectomy
title Safety and Efficacy of Solitaire Stent Thrombectomy
spellingShingle Safety and Efficacy of Solitaire Stent Thrombectomy
Campbell, Bruce C.V|||0000-0003-3632-9433
Endovascular treatment
Intra-arterial therapy
Ischemic stroke
Mechanical thrombectomy
Meta-analysis
Randomized controlled trial
Stent retriever device
Thrombolysis
title_short Safety and Efficacy of Solitaire Stent Thrombectomy
title_full Safety and Efficacy of Solitaire Stent Thrombectomy
title_fullStr Safety and Efficacy of Solitaire Stent Thrombectomy
title_full_unstemmed Safety and Efficacy of Solitaire Stent Thrombectomy
title_sort Safety and Efficacy of Solitaire Stent Thrombectomy
dc.creator.none.fl_str_mv Campbell, Bruce C.V|||0000-0003-3632-9433
Hill, M. D|||0000-0002-6269-1543
Rubiera Del Fueyo, Marta A|||0000-0001-8100-9477
Menon, Bijoy K.
Demchuk, Andrew
Donnan, Geoffrey A.
Roy, Daniel
Thornton, John
Dorado Bouix, Laura|||0000-0003-1095-6797
Bonafe, Alain
Levy, Elad I.
Diener, Hans-Christoph|||0000-0002-6556-8612
Hernández-Pérez, María|||0000-0001-8279-7954
Pereira, Vitor Mendes
Blasco, Jordi
Quesada, Helena|||0009-0009-1846-0447
Rempel, Jeremy
Jahan, Reza
Davis, Stephen M.
Stouch, Bruce C.
Mitchell, Peter J.
Jovin, Tudor G.|||0000-0002-2619-6975
Saver, Jeffrey L..
Goyal, Mayank
author Campbell, Bruce C.V|||0000-0003-3632-9433
author_facet Campbell, Bruce C.V|||0000-0003-3632-9433
Hill, M. D|||0000-0002-6269-1543
Rubiera Del Fueyo, Marta A|||0000-0001-8100-9477
Menon, Bijoy K.
Demchuk, Andrew
Donnan, Geoffrey A.
Roy, Daniel
Thornton, John
Dorado Bouix, Laura|||0000-0003-1095-6797
Bonafe, Alain
Levy, Elad I.
Diener, Hans-Christoph|||0000-0002-6556-8612
Hernández-Pérez, María|||0000-0001-8279-7954
Pereira, Vitor Mendes
Blasco, Jordi
Quesada, Helena|||0009-0009-1846-0447
Rempel, Jeremy
Jahan, Reza
Davis, Stephen M.
Stouch, Bruce C.
Mitchell, Peter J.
Jovin, Tudor G.|||0000-0002-2619-6975
Saver, Jeffrey L..
Goyal, Mayank
author_role author
author2 Hill, M. D|||0000-0002-6269-1543
Rubiera Del Fueyo, Marta A|||0000-0001-8100-9477
Menon, Bijoy K.
Demchuk, Andrew
Donnan, Geoffrey A.
Roy, Daniel
Thornton, John
Dorado Bouix, Laura|||0000-0003-1095-6797
Bonafe, Alain
Levy, Elad I.
Diener, Hans-Christoph|||0000-0002-6556-8612
Hernández-Pérez, María|||0000-0001-8279-7954
Pereira, Vitor Mendes
Blasco, Jordi
Quesada, Helena|||0009-0009-1846-0447
Rempel, Jeremy
Jahan, Reza
Davis, Stephen M.
Stouch, Bruce C.
Mitchell, Peter J.
Jovin, Tudor G.|||0000-0002-2619-6975
Saver, Jeffrey L..
Goyal, Mayank
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona
dc.subject.none.fl_str_mv Endovascular treatment
Intra-arterial therapy
Ischemic stroke
Mechanical thrombectomy
Meta-analysis
Randomized controlled trial
Stent retriever device
Thrombolysis
topic Endovascular treatment
Intra-arterial therapy
Ischemic stroke
Mechanical thrombectomy
Meta-analysis
Randomized controlled trial
Stent retriever device
Thrombolysis
description Supplemental Digital Content is available in the text. Patient-level data were pooled from trials in which the Solitaire was the only or the predominant device used in a prespecified meta-analysis (SEER Collaboration): Solitaire FR With the Intention for Thrombectomy as Primary Endovascular Treatment (SWIFT PRIME), Endovascular Treatment for Small Core and Anterior Circulation Proximal Occlusion With Emphasis on Minimizing CT to Recanalization Times (ESCAPE), Extending the Time for Thrombolysis in Emergency Neurological Deficits-Intra-Arterial (EXTEND-IA), and Randomized Trial of Revascularization With Solitaire FR Device Versus Best Medical Therapy in the Treatment of Acute Stroke Due to Anterior Circulation Large Vessel Occlusion Presenting Within Eight Hours of Symptom Onset (REVASCAT). The primary outcome was ordinal analysis of modified Rankin Score at 90 days. The primary analysis included all patients in the 4 trials with 2 sensitivity analyses: (1) excluding patients in whom Solitaire was not the first device used and (2) including the 3 Solitaire-only trials (excluding ESCAPE). Secondary outcomes included functional independence (modified Rankin Score 0-2), symptomatic intracerebral hemorrhage, and mortality. The primary analysis included 787 patients: 401 randomized to endovascular thrombectomy and 386 to standard care, and 82.6% received intravenous thrombolysis. The common odds ratio for modified Rankin Score improvement was 2.7 (2.0-3.5) with no heterogeneity in effect by age, sex, baseline stroke severity, extent of computed tomography changes, site of occlusion, or pretreatment with alteplase. The number needed to treat to reduce disability was 2.5 and for an extra patient to achieve independent outcome was 4.25 (3.29-5.99). Successful revascularization occurred in 77% treated with Solitaire device. The rate of symptomatic intracerebral hemorrhage and overall mortality did not differ between treatment groups. Solitaire thrombectomy for large vessel ischemic stroke was safe and highly effective with substantially reduced disability. Benefits were consistent in all prespecified subgroups.
publishDate 2016
dc.date.none.fl_str_mv 2
2016-01-01
2016
2016-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/185801
https://dx.doi.org/urn:doi:10.1161/STROKEAHA.115.012360
url https://ddd.uab.cat/record/185801
https://dx.doi.org/urn:doi:10.1161/STROKEAHA.115.012360
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
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dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
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eu_rights_str_mv openAccess
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instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
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