P64 NIMBUS geometric clot extractor for tough clots: SPERO study results and clot composition

Berg, René van den; Ribó, Marc; Arnberg, Fabian; Estrade, Laurent; Thornton, John; Weitz, Alejandro Tomasello; Gontu, Vamsi; Karam, Arnaud; Hernández, David García; Clarençon, Frédéric; Jh, Buhk; Wiesmann, Martin; Nouri, N; Bricout, Nicolas; Desal, H; Januel, A.C.; Doyle, Karen; Liebeskind, David S; Brouwer, P; Andersson, T.

doi:10.1136/neurintsurg-2022-esmint.85

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“…Finally, as the field evolves, it can also be assumed that other therapeutic alternatives may become widely available in the future, such as devices for fibrin-rich tough clots recently evaluated in the Post Marketing Study of Patients to Evaluate NIMBUS Revascularization Effectiveness With Challenging Occlusions (SPERO) Study 29…”

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confidence: 99%

Rescue intracranial permanent stenting for refractory occlusion following thrombectomy: a propensity matched analysis

Ifergan

Dargazanli

Hassen

et al. 2023

J NeuroIntervent Surg

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BackgroundRescue intracranial stenting (RIS) can be used in refractory large vessel occlusion (LVO) after mechanical thrombectomy (MT). We aimed to assess the safety and efficacy of RIS versus a propensity matched sample of patients with persistent LVO.MethodsWe retrospectively analysed a multicenter retrospective pooled cohort of patients with anterior LVO (2015−2021) treated with MT, and identified patients with at least three passes and a modified Thrombolysis In Cerebral Infarction (mTICI) score of 0 to 2a. Propensity score matching was used to account for determinants of outcome in patients with or without RIS. The study outcomes included 3 months modified Rankin Scale (mRS) and symptomatic hemorrhagic transformation (HT).Results420 patients with a refractory anterior occlusion were included, of which 101 were treated with RIS (mean age 69 years). Favorable outcome (mRS 0–2) was more frequent in patients with a patent stent at day 1 (53% vs 6%, P<0.001), which was independently associated with an early dual antiplatelet regimen (P<0.05). In the propensity matched sample, patients treated with RIS versus without RIS had similar rates of favorable outcomes (36.8% vs 30.3%, P=0.606). Patients with RIS showed a favorable shift in the overall mRS distributions (common adjusted OR 0.74, 95% CI 0.60 to 0.91, P=0.006). Symptomatic HT was marginally more frequent in the RIS group (9% vs 3%, P=0.07), and there was no difference in 3-month mortality.ConclusionIn selected patients with a refractory intracranial occlusion despite at least three thrombectomy passes, RIS may be associated with an overall shift towards more favorable clinical outcome, and no significant increase in the odds of symptomatic HT or death.

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Section: Discussionmentioning

confidence: 99%

Rescue intracranial permanent stenting for refractory occlusion following thrombectomy: a propensity matched analysis

Ifergan

Dargazanli

Hassen

et al. 2023

J NeuroIntervent Surg

View full text Add to dashboard Cite

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P64 NIMBUS geometric clot extractor for tough clots: SPERO study results and clot composition

Abstract: Conclusions CEA and CAS have both been used to treat carotid webs although CAS is more commonly reported in the published literature. Both procedures appear highly effective at preventing recurrent stroke. The safety profile of both procedures is good with no deaths recorded.

Cited by 1 publication

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Rescue intracranial permanent stenting for refractory occlusion following thrombectomy: a propensity matched analysis

Rescue intracranial permanent stenting for refractory occlusion following thrombectomy: a propensity matched analysis

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