Come and join us across the globe
Dr. Jildaz Caroff
Interventional Neuroradiology
Neuri Brain Vascular Center
Bicêtre Hospital AP-HP
Paris
This article by Zaidat et al delves into the standard treatment for acute stroke, which involves the utilization of stent-retrievers to extract clots.
While several studies have individually examined the outcomes of three commonly used stent-retrievers (EmboTrap™, Solitaire™, and Trevo™), there is a scarcity of research directly comparing these devices. In the MASTRO I study, the authors systematically reviewed various studies that reported stroke outcomes with these devices. The aim was to combine and compare the findings to determine whether any device outperformed the others in terms of improving functional deficits, successful clot removal, and patient safety (such as reducing brain hemorrhage, formation of distal clot fragments, and mortality).
What were the results?
The analysis incorporated 51 studies, encompassing 9,804 patients who received treatment for acute stroke using one of the three devices. Upon combining and comparing the data from these studies, none of the devices demonstrated a significant advantage in terms of clot removal rates. However, EmboTrap™ exhibited significantly better rates of achieving good neurological function compared to both Trevo™ and Solitaire™. In terms of safety, Solitaire™ had notably higher rates of brain hemorrhage and mortality compared to both EmboTrap™ and Trevo™. The rate of distal clot fragment formation appeared to be similar across all three devices.
Source: Journal of Comparative Effectiveness Research
What are the implications of the results?
The insights derived from this comparative research review can assist physicians in making evidence-based decisions regarding the selection of devices for acute stroke treatment. It is important to note that potential biases may be present in the 51 studies included in this review, as there is a high risk of comparing patient groups and treatment approaches that may not be entirely similar. Therefore, it is emphasized that more randomized trials, accounting for differences in study parameters, are necessary to confirm these findings. Two ongoing randomized controlled trials are currently addressing this need.
Supported by
