Mechanical Thrombectomy with the Embolus Retriever with Interlinked Cages in Acute Ischemic Stroke: ERIC, the New Boy in the Class

TY - JOUR

T1 - Mechanical Thrombectomy with the Embolus Retriever with Interlinked Cages in Acute Ischemic Stroke

T2 - ERIC, the New Boy in the Class

AU - Steglich-Arnholm, H

AU - Kondziella, D

AU - Wagner, A

AU - Cronqvist, M E

AU - Hansen, K

AU - Truelsen, T C

AU - Krarup, L-H

AU - Højgaard, J L S

AU - Taudorf, S

AU - Iversen, H K

AU - Krieger, D W

AU - Holtmannspötter, M

N1 - © 2017 by American Journal of Neuroradiology.

PY - 2017/7/1

Y1 - 2017/7/1

N2 - BACKGROUND AND PURPOSE: The Embolus Retriever with Interlinked Cages (ERIC) device is a novel stent retriever for mechanical thrombectomy. It consists of interlinked cages and could improve procedural benchmarks and clinical outcome compared with classic stent retrievers. This study compares the rates of recanalization, favorable clinical outcome, procedural adverse events, and benchmarks between the ERIC device and classic stent retrievers.MATERIALS AND METHODS: From 545 patients treated with thrombectomy between 2012 and 2015, 316 patients were included. The mean age was 69 ±13 years, the mean baseline NIHSS score was 17 ± 5, and 174 (55%) were men. The ERIC was used as the primary thrombectomy device in 59 (19%) patients. In a propensity score matched analysis including the NIHSS score, clot location, delay to groin puncture, neurointerventionalist, and anesthetic management, 57 matched pairs were identified.RESULTS: Patients treated with the ERIC device compared with classic stent retrievers showed equal rates of recanalization (86% versus 81%,P= .61), equal favorable 3-month clinical outcome (mRS 0-2: 46% versus 40%,P= .71), and procedural adverse events (28% versus 30%,P= 1.00). However, in patients treated with the ERIC device, thrombectomy procedures were less time-consuming (67 versus 98 minutes,P= .009) and a rescue device was needed less often (18% versus 39%,P= .02) compared with classic stent retrievers.CONCLUSIONS: Mechanical thrombectomy with the ERIC device is effective and safe. Rates of favorable procedural and clinical outcomes are at least as good as those with classic stent retrievers. Of note, the ERIC device might be time-saving and decrease the need for rescue devices. These promising results call for replication in larger prospective clinical trials.

AB - BACKGROUND AND PURPOSE: The Embolus Retriever with Interlinked Cages (ERIC) device is a novel stent retriever for mechanical thrombectomy. It consists of interlinked cages and could improve procedural benchmarks and clinical outcome compared with classic stent retrievers. This study compares the rates of recanalization, favorable clinical outcome, procedural adverse events, and benchmarks between the ERIC device and classic stent retrievers.MATERIALS AND METHODS: From 545 patients treated with thrombectomy between 2012 and 2015, 316 patients were included. The mean age was 69 ±13 years, the mean baseline NIHSS score was 17 ± 5, and 174 (55%) were men. The ERIC was used as the primary thrombectomy device in 59 (19%) patients. In a propensity score matched analysis including the NIHSS score, clot location, delay to groin puncture, neurointerventionalist, and anesthetic management, 57 matched pairs were identified.RESULTS: Patients treated with the ERIC device compared with classic stent retrievers showed equal rates of recanalization (86% versus 81%,P= .61), equal favorable 3-month clinical outcome (mRS 0-2: 46% versus 40%,P= .71), and procedural adverse events (28% versus 30%,P= 1.00). However, in patients treated with the ERIC device, thrombectomy procedures were less time-consuming (67 versus 98 minutes,P= .009) and a rescue device was needed less often (18% versus 39%,P= .02) compared with classic stent retrievers.CONCLUSIONS: Mechanical thrombectomy with the ERIC device is effective and safe. Rates of favorable procedural and clinical outcomes are at least as good as those with classic stent retrievers. Of note, the ERIC device might be time-saving and decrease the need for rescue devices. These promising results call for replication in larger prospective clinical trials.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Anesthesia

KW - Brain Ischemia/surgery

KW - Case-Control Studies

KW - Device Removal

KW - Female

KW - Groin

KW - Humans

KW - Intracranial Embolism/surgery

KW - Male

KW - Middle Aged

KW - Postoperative Care

KW - Propensity Score

KW - Punctures

KW - Retrospective Studies

KW - Stents

KW - Stroke/surgery

KW - Surgical Instruments/adverse effects

KW - Thrombectomy/adverse effects

KW - Treatment Outcome

U2 - 10.3174/ajnr.a5201

DO - 10.3174/ajnr.a5201

M3 - Journal article

C2 - 28495947

SN - 0195-6108

VL - 38

SP - 1356

EP - 1361

JO - American Journal of Neuroradiology

JF - American Journal of Neuroradiology

IS - 7

ER -