Trevo System: Single‐Center Experience with a Novel Mechanical Thrombectomy Device

Abstract

Recent reports have indicated that mechanical thrombectomy may have the potential to treat acute ischemic stroke. This study aims to describe the safety and effectiveness of Trevo Retriever, using Stentriever technology, in revascularization of patients with acute ischemic stroke. METHODSProspective study evaluating the clinical, radiological, and functional outcome of 13 patients with an angiographically verified occlusion of the anterior cerebral circulation. All patients underwent thrombectomy with TR as monotherapy or in combination with intraarterial thrombolysis, within the first 8 hours from the onset of symptoms. Successful revascularization was defined as thrombolysis in cerebral ischemia grade 2a to 3. Good outcome was defined as modified Rankin Scale score ≤ 2. RESULTS Median baseline National Institutes of Health CONCLUSIONEarly clinical experience suggests that the TR can allow safe and effective revascularization in certain subjects with acute ischemic stroke.

Safety and Efficacy of Endovascular Sonolysis Using the EkoSonic Endovascular System in Patients with Acute Stroke

“…Favorable clinical outcome (defined as mRS, 0 -2) ranged from 36% up to 74%. [10][11][12][13][14][15][16][17][18][19] The present study showed that the prevalence of recanalization and favorable outcome in patients treated by endovascular sonolysis in combination with local or systemic thrombolysis (and cPTAS if indicated) was comparable with (or even superior to) other endovascular methods, especially in patients with MCA occlusion. Moreover, it seemed to be safer.…”

“…In addition to pharmacologic methods, especially IV thrombolysis and intraarterial thrombolysis, mechanical neurointerventional methods ( [10][11][12][13][14][15][16][17][18][19] One of these, the EkoSonic Endovascular System, is the first tool system approved by the FDA that allows local endovascular application of high-frequency (2 MHz) and low-power (400 W/cm 2 ) sonography in clinical practice with or without simultaneous catheter-directed thrombolysis by application of thrombolytic drugs. [22][23][24] Several in vitro, in vivo, and clinical studies have shown the potential effect of sonography (sonolysis) to accelerate clot lysis.…”

“…5 The options for acceleration of recanalization of intracranial artery occlusion are the following: IV thrombolysis, IAT, or combined thrombolysis; mechanical recanalization by using several mechanical devices for thrombectomy and/or stent placement; and remote or local sonolysis. [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] Endovascular sonolysis can be used to accelerate and achieve recanalization of intracranial arterial occlusion. [22][23][24] The aim of the present study was to confirm the safety and efficacy of endovascular sonolysis by using the EkoSonic Endovascular System (EKOS, Bothell, Washington) in patients with acute ischemic stroke with occlusion of the middle cerebral artery or basilar artery within 8 hours after stroke onset.…”

Comparison of Solitaire-FR and Trevo-ProVue Thrombectomy in Patients with Anterior Circulation Large Artery Occlusion

“…The TV was designed to facilitate proper visualization of the complete device by integrating the platinum wires into the stent struts itself (16)(17)(18). Full structural visibility of the stent during deployment and retrieval allow procedural adaptation or modification by enhancing the operator's understanding of the actual stent-clot or stent-vessel interaction (16).…”

Selecting Endovascular Treatment Strategy according to the Location of Intracranial Occlusion in Acute Stroke

“…Nonetheless, SICH occurred in 10% of the prourokinase group [3]. On the other hand, in last years the use of several endovascular thrombectomy devices (Merci®, Trevo® or Solitaire®) has been approved by regulatory agencies [4,5]. The Solitaire retriever has recently been tested in a multicenter study showing REC in 85% of occlusions and good outcome in 55% [6].…”