First-Pass Recanalization with EmboTrap II in Acute Ischemic Stroke (FREE-AIS): A Multicenter Prospective Study

Jang Hyun Baek; Byung Moon Kim; Sang Hyun Suh; Hong Jun Jeon; Eun Hyun Ihm; Hyungjong Park; Chang Hyun Kim; Sang Hoon Cha; Chi Hoon Choi; Kyung Sik Yi; Jun Hwee Kim; Sangil Suh; Byungjun Kim; Yoonkyung Chang; So Yeon Kim; Jae Sang Oh; Ji Hoe Heo; Dong Joon Kim; Hyo Suk Nam; Young Dae Kim

doi:10.3348/kjr.2022.0618

First-Pass Recanalization with EmboTrap II in Acute Ischemic Stroke (FREE-AIS): A Multicenter Prospective Study

Jang Hyun Baek, Byung Moon Kim, Sang Hyun Suh, Hong Jun Jeon, Eun Hyun Ihm, Hyungjong Park, Chang Hyun Kim, Sang Hoon Cha, Chi Hoon Choi, Kyung Sik Yi, Jun Hwee Kim, Sangil Suh, Byungjun Kim, Yoonkyung Chang, So Yeon Kim, Jae Sang Oh, Ji Hoe Heo, Dong Joon Kim, Hyo Suk Nam, Young Dae Kim

Department of Neurology

Research output: Contribution to journal › Article › peer-review

Abstract

Objective: We aimed to evaluate the efficacy of EmboTrap II in terms of first-pass recanalization and to determine whether it could yield favorable outcomes. Materials and Methods: In this multicenter, prospective study, we consecutively enrolled patients who underwent mechanical thrombectomy using EmboTrap II as a front-line device. The primary outcome was the first pass effect (FPE) rate defined by modified Thrombolysis In Cerebral Infarction (mTICI) grade 2c or 3 by the first pass of EmboTrap II. In addition, modified FPE (mFPE; mTICI grade 2b-3 by the first pass of EmboTrap II), successful recanalization (final mTICI grade 2b-3), and clinical outcomes were assessed. We also analyzed the effect of FPE on a modified Rankin Scale (mRS) score of 0-2 at 3 months. Results: Two hundred-ten patients (mean age ± standard deviation, 73.3 ± 11.4 years; male, 55.7%) were included. Ninety-nine patients (47.1%) had FPE, and mFPE was achieved in 150 (71.4%) patients. Successful recanalization was achieved in 191 (91.0%) patients. Among them, 164 (85.9%) patients underwent successful recanalization by exclusively using EmboTrap II. The time from groin puncture to FPE was 25.0 minutes (interquartile range, 17.0-35.0 minutes). Procedure-related complications were observed in seven (3.3%) patients. Symptomatic intracranial hemorrhage developed in 14 (6.7%) patients. One hundred twenty-three (58.9% of 209 completely followed) patients had an mRS score of 0-2. Sixteen (7.7% of 209) patients died during the follow-up period. Patients who had successful recanalization with FPE were four times more likely to have an mRS score of 0-2 than those who had successful recanalization without FPE (adjusted odds ratio, 4.13; 95% confidence interval, 1.59-10.8; p = 0.004). Conclusion: Mechanical thrombectomy using the front-line EmboTrap II is effective and safe. In particular, FPE rates were high. Achieving FPE was important for an mRS score of 0-2, even in patients with successful recanalization.

Original language	English
Pages (from-to)	145-154
Number of pages	10
Journal	Korean Journal of Radiology
Volume	24
Issue number	2
DOIs	https://doi.org/10.3348/kjr.2022.0618
State	Published - Feb 2023

Bibliographical note

Publisher Copyright:
© 2023 The Korean Society of Radiology.

Keywords

First-pass recanalization
Stent
Stroke
Thrombectomy

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10.3348/kjr.2022.0618

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Baek, J. H., Kim, B. M., Suh, S. H., Jeon, H. J., Ihm, E. H., Park, H., Kim, C. H., Cha, S. H., Choi, C. H., Yi, K. S., Kim, J. H., Suh, S., Kim, B., Chang, Y., Kim, S. Y., Oh, J. S., Heo, J. H., Kim, D. J., Nam, H. S., & Kim, Y. D. (2023). First-Pass Recanalization with EmboTrap II in Acute Ischemic Stroke (FREE-AIS): A Multicenter Prospective Study. Korean Journal of Radiology, 24(2), 145-154. https://doi.org/10.3348/kjr.2022.0618

@article{9e41a463193949668ff8d3d11ae55dcc,

title = "First-Pass Recanalization with EmboTrap II in Acute Ischemic Stroke (FREE-AIS): A Multicenter Prospective Study",

abstract = "Objective: We aimed to evaluate the efficacy of EmboTrap II in terms of first-pass recanalization and to determine whether it could yield favorable outcomes. Materials and Methods: In this multicenter, prospective study, we consecutively enrolled patients who underwent mechanical thrombectomy using EmboTrap II as a front-line device. The primary outcome was the first pass effect (FPE) rate defined by modified Thrombolysis In Cerebral Infarction (mTICI) grade 2c or 3 by the first pass of EmboTrap II. In addition, modified FPE (mFPE; mTICI grade 2b-3 by the first pass of EmboTrap II), successful recanalization (final mTICI grade 2b-3), and clinical outcomes were assessed. We also analyzed the effect of FPE on a modified Rankin Scale (mRS) score of 0-2 at 3 months. Results: Two hundred-ten patients (mean age ± standard deviation, 73.3 ± 11.4 years; male, 55.7%) were included. Ninety-nine patients (47.1%) had FPE, and mFPE was achieved in 150 (71.4%) patients. Successful recanalization was achieved in 191 (91.0%) patients. Among them, 164 (85.9%) patients underwent successful recanalization by exclusively using EmboTrap II. The time from groin puncture to FPE was 25.0 minutes (interquartile range, 17.0-35.0 minutes). Procedure-related complications were observed in seven (3.3%) patients. Symptomatic intracranial hemorrhage developed in 14 (6.7%) patients. One hundred twenty-three (58.9% of 209 completely followed) patients had an mRS score of 0-2. Sixteen (7.7% of 209) patients died during the follow-up period. Patients who had successful recanalization with FPE were four times more likely to have an mRS score of 0-2 than those who had successful recanalization without FPE (adjusted odds ratio, 4.13; 95% confidence interval, 1.59-10.8; p = 0.004). Conclusion: Mechanical thrombectomy using the front-line EmboTrap II is effective and safe. In particular, FPE rates were high. Achieving FPE was important for an mRS score of 0-2, even in patients with successful recanalization.",

keywords = "First-pass recanalization, Stent, Stroke, Thrombectomy",

author = "Baek, {Jang Hyun} and Kim, {Byung Moon} and Suh, {Sang Hyun} and Jeon, {Hong Jun} and Ihm, {Eun Hyun} and Hyungjong Park and Kim, {Chang Hyun} and Cha, {Sang Hoon} and Choi, {Chi Hoon} and Yi, {Kyung Sik} and Kim, {Jun Hwee} and Sangil Suh and Byungjun Kim and Yoonkyung Chang and Kim, {So Yeon} and Oh, {Jae Sang} and Heo, {Ji Hoe} and Kim, {Dong Joon} and Nam, {Hyo Suk} and Kim, {Young Dae}",

note = "Publisher Copyright: {\textcopyright} 2023 The Korean Society of Radiology.",

year = "2023",

month = feb,

doi = "10.3348/kjr.2022.0618",

language = "English",

volume = "24",

pages = "145--154",

journal = "Korean Journal of Radiology",

issn = "1229-6929",

publisher = "Korean Radiological Society",

number = "2",

}

Baek, JH, Kim, BM, Suh, SH, Jeon, HJ, Ihm, EH, Park, H, Kim, CH, Cha, SH, Choi, CH, Yi, KS, Kim, JH, Suh, S, Kim, B, Chang, Y, Kim, SY, Oh, JS, Heo, JH, Kim, DJ, Nam, HS & Kim, YD 2023, 'First-Pass Recanalization with EmboTrap II in Acute Ischemic Stroke (FREE-AIS): A Multicenter Prospective Study', Korean Journal of Radiology, vol. 24, no. 2, pp. 145-154. https://doi.org/10.3348/kjr.2022.0618

TY - JOUR

T1 - First-Pass Recanalization with EmboTrap II in Acute Ischemic Stroke (FREE-AIS)

T2 - A Multicenter Prospective Study

AU - Baek, Jang Hyun

AU - Kim, Byung Moon

AU - Suh, Sang Hyun

AU - Jeon, Hong Jun

AU - Ihm, Eun Hyun

AU - Park, Hyungjong

AU - Kim, Chang Hyun

AU - Cha, Sang Hoon

AU - Choi, Chi Hoon

AU - Yi, Kyung Sik

AU - Kim, Jun Hwee

AU - Suh, Sangil

AU - Kim, Byungjun

AU - Chang, Yoonkyung

AU - Kim, So Yeon

AU - Oh, Jae Sang

AU - Heo, Ji Hoe

AU - Kim, Dong Joon

AU - Nam, Hyo Suk

AU - Kim, Young Dae

PY - 2023/2

Y1 - 2023/2

N2 - Objective: We aimed to evaluate the efficacy of EmboTrap II in terms of first-pass recanalization and to determine whether it could yield favorable outcomes. Materials and Methods: In this multicenter, prospective study, we consecutively enrolled patients who underwent mechanical thrombectomy using EmboTrap II as a front-line device. The primary outcome was the first pass effect (FPE) rate defined by modified Thrombolysis In Cerebral Infarction (mTICI) grade 2c or 3 by the first pass of EmboTrap II. In addition, modified FPE (mFPE; mTICI grade 2b-3 by the first pass of EmboTrap II), successful recanalization (final mTICI grade 2b-3), and clinical outcomes were assessed. We also analyzed the effect of FPE on a modified Rankin Scale (mRS) score of 0-2 at 3 months. Results: Two hundred-ten patients (mean age ± standard deviation, 73.3 ± 11.4 years; male, 55.7%) were included. Ninety-nine patients (47.1%) had FPE, and mFPE was achieved in 150 (71.4%) patients. Successful recanalization was achieved in 191 (91.0%) patients. Among them, 164 (85.9%) patients underwent successful recanalization by exclusively using EmboTrap II. The time from groin puncture to FPE was 25.0 minutes (interquartile range, 17.0-35.0 minutes). Procedure-related complications were observed in seven (3.3%) patients. Symptomatic intracranial hemorrhage developed in 14 (6.7%) patients. One hundred twenty-three (58.9% of 209 completely followed) patients had an mRS score of 0-2. Sixteen (7.7% of 209) patients died during the follow-up period. Patients who had successful recanalization with FPE were four times more likely to have an mRS score of 0-2 than those who had successful recanalization without FPE (adjusted odds ratio, 4.13; 95% confidence interval, 1.59-10.8; p = 0.004). Conclusion: Mechanical thrombectomy using the front-line EmboTrap II is effective and safe. In particular, FPE rates were high. Achieving FPE was important for an mRS score of 0-2, even in patients with successful recanalization.

AB - Objective: We aimed to evaluate the efficacy of EmboTrap II in terms of first-pass recanalization and to determine whether it could yield favorable outcomes. Materials and Methods: In this multicenter, prospective study, we consecutively enrolled patients who underwent mechanical thrombectomy using EmboTrap II as a front-line device. The primary outcome was the first pass effect (FPE) rate defined by modified Thrombolysis In Cerebral Infarction (mTICI) grade 2c or 3 by the first pass of EmboTrap II. In addition, modified FPE (mFPE; mTICI grade 2b-3 by the first pass of EmboTrap II), successful recanalization (final mTICI grade 2b-3), and clinical outcomes were assessed. We also analyzed the effect of FPE on a modified Rankin Scale (mRS) score of 0-2 at 3 months. Results: Two hundred-ten patients (mean age ± standard deviation, 73.3 ± 11.4 years; male, 55.7%) were included. Ninety-nine patients (47.1%) had FPE, and mFPE was achieved in 150 (71.4%) patients. Successful recanalization was achieved in 191 (91.0%) patients. Among them, 164 (85.9%) patients underwent successful recanalization by exclusively using EmboTrap II. The time from groin puncture to FPE was 25.0 minutes (interquartile range, 17.0-35.0 minutes). Procedure-related complications were observed in seven (3.3%) patients. Symptomatic intracranial hemorrhage developed in 14 (6.7%) patients. One hundred twenty-three (58.9% of 209 completely followed) patients had an mRS score of 0-2. Sixteen (7.7% of 209) patients died during the follow-up period. Patients who had successful recanalization with FPE were four times more likely to have an mRS score of 0-2 than those who had successful recanalization without FPE (adjusted odds ratio, 4.13; 95% confidence interval, 1.59-10.8; p = 0.004). Conclusion: Mechanical thrombectomy using the front-line EmboTrap II is effective and safe. In particular, FPE rates were high. Achieving FPE was important for an mRS score of 0-2, even in patients with successful recanalization.

KW - First-pass recanalization

KW - Stent

KW - Stroke

KW - Thrombectomy

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U2 - 10.3348/kjr.2022.0618

DO - 10.3348/kjr.2022.0618

M3 - Article

C2 - 36725355

AN - SCOPUS:85147235395

SN - 1229-6929

VL - 24

SP - 145

EP - 154

JO - Korean Journal of Radiology

JF - Korean Journal of Radiology

IS - 2

ER -

First-Pass Recanalization with EmboTrap II in Acute Ischemic Stroke (FREE-AIS): A Multicenter Prospective Study

Abstract

Bibliographical note

Keywords

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