Effectiveness of Trevo stent retriever in acute ischemic stroke: Comparison with Solitaire stent.

Abstract

Recently, mechanical thrombectomy with stent retriever has achieved faster and higher rates of recanalization for intracranial major vessel occlusion. However, comparative studies of the most widely used Solitaire and Trevo stents have been rarely published.The authors retrospectively reviewed a total of 200 patients who performed mechanical thrombectomy at our center during 4 years and divided patients into 2 groups: mechanical thrombectomy with Solitaire stent (Group 1: Solitaire) and mechanical thrombectomy with Trevo stent (Group 2: Trevo). All patients underwent a clinical assessment with National Institutes of Health Stroke Scale (NIHSS) score and underwent modified Rankin Scale (mRS) score. Radiologic results were evaluated using thrombolysis in cerebral infarction (TICI) score and number of stent passes. In addition, multiple time intervals were analyzed.There was no statistically significant difference in clinical outcome between the 2 groups. Trevo group revealed the shorter procedure time, less number of stent passage, and more one pass cases than Solitaire group with statistically significance (P = .009, P = .014, P = .030). In addition, Trevo group achieved higher successful recanalization (TICI 2b or 3) rate (89.7%) with statically significant than group1 (82.3%) (P = .018). In multivariate logistic regression analysis, the use of Trevo stent was a predictive for successful recanalization. (odds ratio 1.40, 95% confidence interval 1.250–1.550, P = .028).Our study suggests that the Trevo stent allows higher recanalization rate through the less number of stent passages and shorter procedure time than the Solitaire stent. More randomized control trials are needed to determine which stents are more effective.