Elena Zapata-Arriaza, MD
Zaidat OO, Haussen DC, Hassan AE, Jadhav AP, Mehta BP, Mokin M, et al. Impact of Stent Retriever Size on Clinical and Angiographic Outcomes in the STRATIS Stroke Thrombectomy Registry. Stroke. 2019;50:441–447.
The introduction of stent retriever has involved a great advance in the reperfusion treatment of acute ischemic stroke with large vessel occlusion. Stent retriever has increased procedural success, leading the American Heart Association/American Stroke Association guidelines to recommend the use of stent retrievers for mechanical thrombectomy within 8 hours of symptom onset. However, some concerns related to the safety and efficacy of the stent retriever are maintained regarding its diameter and size.
To answer the question, Zaidat et al. performed a retrospective ad hoc analysis of data from the STRATIS registry (a prospective, multicenter study of patients with large vessel occlusion treated with the Solitaire stent retriever). Main angiographic end points were first-pass effect (FPE), defined as modified thrombolysis in cerebral infarction (mTICI) ≥2c recanalization grade after the first pass without the use of rescue therapy, and rates of modified FPE (mFPE), defined as meeting all criteria for FPE but achieving mTICI ≥2b after first pass. The primary clinical endpoint was functional independence (modified Rankin scale, 0–2) at 3 months as determined on-site. Rates of distal embolization, embolization into new territory, and final mTICI among others were evaluated as well.