Analysis of revascularisation in ischaemic stroke with EmboTrap (ARISE I study) and meta-analysis of thrombectomy

Mattle, Heinrich; Scarrott, C.; Claffey, M.; Thornton, J.; Macho, J.; Riedel, C.; Soderman, M.; Bonafe, A.; Piotin, M.; Newell, J.; Andersson, T. (2019). Analysis of revascularisation in ischaemic stroke with EmboTrap (ARISE I study) and meta-analysis of thrombectomy. Interventional neuroradiology, 25(3), pp. 261-270. Sage Publications 10.1177/1591019918817406

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BACKGROUND AND PURPOSE: The goal of the analysis of revascularisation in ischaemic stroke with EmboTrap study (ARISE I) was to demonstrate the effectiveness of EmboTrap. METHODS: ARISE I was an open label, single arm, multicentre, prospective study for the treatment of acute stroke due to large vessel occlusion. The primary outcome was revascularisation of the target vessel as measured by the modified thrombolysis in cerebrovascular infarction (mTICI) score of at least 2b following thrombectomy with EmboTrap. For comparison of the ARISE I results a meta-analysis of eight randomised controlled trials was performed. RESULTS: ARISE I enrolled 40 patients. Their baseline characteristics that are predictors of stroke outcome and procedure timings in ARISE I were similar to those reported in recent randomised controlled trials. The primary outcome, good revascularisation rates (mTICI 2b/3 scores) after three or fewer passes with EmboTrap were 75 (95 confidence interval (CI) 62-88), which is the same as 74 found in randomised controlled trials (difference of 0.8, P = 0.95). After additional EmboTrap passes or the use of another device mTICI 2b/3 scores rose to 85 (95 CI 74-96), which was also similar to the randomised controlled trials (difference 11, P = 0.38). The high revascularisation rates in ARISE I converted into 64 good clinical outcomes (modified Rankin scale </=2) compared to 50 in randomised controlled trials (difference 14; 95 CI -13.7-41.7; P = 0.32). CONCLUSIONS: ARISE I demonstrates that thrombectomy using the EmboTrap stent retriever yields similar results to devices that were used in recent randomised controlled trials for the treatment of stroke due to large vessel occlusions. ClinicalTrials.gov identifier NCT02190552.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Mattle, Heinrich

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1591-0199

Publisher:

Sage Publications

Language:

English

Submitter:

Panagiota Milona

Date Deposited:

28 Jan 2019 16:23

Last Modified:

31 May 2019 01:31

Publisher DOI:

10.1177/1591019918817406

PubMed ID:

30563388

Uncontrolled Keywords:

Ischaemic stroke mechanical thrombectomy meta-analysis stent retriever

URI:

https://boris.unibe.ch/id/eprint/124735

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