Systematic evaluation of patients treated with neurothrombectomy devices for acute ischemic stroke primary results of the STRATIS registry

Nils H. Mueller-Kronast; Osama O. Zaidat; Michael T. Froehler; Reza Jahan; Mohammad Ali Aziz-Sultan; Richard P. Klucznik; Jeffrey L. Saver; Frank R. Hellinger; Dileep R. Yavagal; Tom L. Yao; David S. Liebeskind; Ashutosh P. Jadhav; Rishi Gupta; Ameer E. Hassan; Coleman O. Martin; Hormozd Bozorgchami; Ritesh Kaushal; Raul G. Nogueira; Ravi H. Gandhi; Eric C. Peterson; Shervin R. Dashti; Curtis A. Given; Brijesh P. Mehta; Vivek Deshmukh; Sidney Starkman; Italo Linfante; Scott H. McPherson; Peter Kvamme; Thomas J. Grobelny; Muhammad S. Hussain; Ike Thacker; Nirav Vora; Peng Roc Chen; Stephen J. Monteith; Robert D. Ecker; Clemens M. Schirmer; Eric Sauvageau; Alex Abou-Chebl; Colin P. Derdeyn; Lucian Maidan; Aamir Badruddin; Adnan H. Siddiqui; Travis M. Dumont; Abdulnasser Alhajeri; M. Asif Taqi; Khaled Asi; Jeffrey Carpenter; Alan Boulos; Gaurav Jindal; Ajit S. Puri; Rohan Chitale; Eric M. Deshaies; David H. Robinson; David F. Kallmes; Blaise W. Baxter; Mouhammad A. Jumaa; Peter Sunenshine; Aniel Majjhoo; Joey D. English; Shuichi Suzuki; Richard D. Fessler; Josser E.Delgado Almandoz; Jerry C. Martin; Diogo C. Haussen

doi:10.1161/STROKEAHA.117.016456

Systematic evaluation of patients treated with neurothrombectomy devices for acute ischemic stroke primary results of the STRATIS registry

Nils H. Mueller-Kronast, Osama O. Zaidat, Michael T. Froehler, Reza Jahan, Mohammad Ali Aziz-Sultan, Richard P. Klucznik, Jeffrey L. Saver, Frank R. Hellinger, Dileep R. Yavagal, Tom L. Yao, David S. Liebeskind, Ashutosh P. Jadhav, Rishi Gupta, Ameer E. Hassan, Coleman O. Martin, Hormozd Bozorgchami, Ritesh Kaushal, Raul G. Nogueira, Ravi H. Gandhi, Eric C. PetersonShervin R. Dashti, Curtis A. Given, Brijesh P. Mehta, Vivek Deshmukh, Sidney Starkman, Italo Linfante, Scott H. McPherson, Peter Kvamme, Thomas J. Grobelny, Muhammad S. Hussain, Ike Thacker, Nirav Vora, Peng Roc Chen, Stephen J. Monteith, Robert D. Ecker, Clemens M. Schirmer, Eric Sauvageau, Alex Abou-Chebl, Colin P. Derdeyn, Lucian Maidan, Aamir Badruddin, Adnan H. Siddiqui, Travis M. Dumont, Abdulnasser Alhajeri, M. Asif Taqi, Khaled Asi, Jeffrey Carpenter, Alan Boulos, Gaurav Jindal, Ajit S. Puri, Rohan Chitale, Eric M. Deshaies, David H. Robinson, David F. Kallmes, Blaise W. Baxter, Mouhammad A. Jumaa, Peter Sunenshine, Aniel Majjhoo, Joey D. English, Shuichi Suzuki, Richard D. Fessler, Josser E.Delgado Almandoz, Jerry C. Martin, Diogo C. Haussen

Radiology

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

84 Scopus citations

Abstract

Background and Purpose-Mechanical thrombectomy with stent retrievers has become standard of care for treatment of acute ischemic stroke patients because of large vessel occlusion. The STRATIS registry (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke) aimed to assess whether similar process timelines, technical, and functional outcomes could be achieved in a large real world cohort as in the randomized trials. Methods-STRATIS was designed to prospectively enroll patients treated in the United States with a Solitaire Revascularization Device and Mindframe Capture Low Profile Revascularization Device within 8 hours from symptom onset. The STRATIS cohort was compared with the interventional cohort of a previously published SEER patient-level meta-analysis. Results-A total of 984 patients treated at 55 sites were analyzed. The mean National Institutes of Health Stroke Scale score was 17.3. Intravenous tissue-type plasminogen activator was administered in 64.0%. The median time from onset to arrival in the enrolling hospital, door to puncture, and puncture to reperfusion were 138, 72, and 36 minutes, respectively. The Core lab-adjudicated modified Thrombolysis in Cerebral Infarction ≥2b was achieved in 87.9% of patients. At 90 days, 56.5% achieved a modified Rankin Scale score of 0 to 2, all-cause mortality was 14.4%, and 1.4% suffered a symptomatic intracranial hemorrhage. The median time from emergency medical services scene arrival to puncture was 152 minutes, and each hour delay in this interval was associated with a 5.5% absolute decline in the likelihood of achieving modified Rankin Scale score 0 to 2. Conclusions-This largest-to-date Solitaire registry documents that the results of the randomized trials can be reproduced in the community. The decrease of clinical benefit over time warrants optimization of the system of care.

Original language	English (US)
Pages (from-to)	2760-2768
Number of pages	9
Journal	Stroke
Volume	48
Issue number	10
DOIs	https://doi.org/10.1161/STROKEAHA.117.016456
State	Published - Oct 2017

Keywords

Ischemic stroke
Mindframe capture
Registry
Solitaire
Stent
System of care
Thrombectomy

ASJC Scopus subject areas

Clinical Neurology
Cardiology and Cardiovascular Medicine
Advanced and Specialized Nursing

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10.1161/STROKEAHA.117.016456

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Mueller-Kronast, N. H., Zaidat, O. O., Froehler, M. T., Jahan, R., Aziz-Sultan, M. A., Klucznik, R. P., Saver, J. L., Hellinger, F. R., Yavagal, D. R., Yao, T. L., Liebeskind, D. S., Jadhav, A. P., Gupta, R., Hassan, A. E., Martin, C. O., Bozorgchami, H., Kaushal, R., Nogueira, R. G., Gandhi, R. H., ... Haussen, D. C. (2017). Systematic evaluation of patients treated with neurothrombectomy devices for acute ischemic stroke primary results of the STRATIS registry. Stroke, 48(10), 2760-2768. https://doi.org/10.1161/STROKEAHA.117.016456

Mueller-Kronast, NH, Zaidat, OO, Froehler, MT, Jahan, R, Aziz-Sultan, MA, Klucznik, RP, Saver, JL, Hellinger, FR, Yavagal, DR, Yao, TL, Liebeskind, DS, Jadhav, AP, Gupta, R, Hassan, AE, Martin, CO, Bozorgchami, H, Kaushal, R, Nogueira, RG, Gandhi, RH, Peterson, EC, Dashti, SR, Given, CA, Mehta, BP, Deshmukh, V, Starkman, S, Linfante, I, McPherson, SH, Kvamme, P, Grobelny, TJ, Hussain, MS, Thacker, I, Vora, N, Chen, PR, Monteith, SJ, Ecker, RD, Schirmer, CM, Sauvageau, E, Abou-Chebl, A, Derdeyn, CP, Maidan, L, Badruddin, A, Siddiqui, AH, Dumont, TM, Alhajeri, A, Taqi, MA, Asi, K, Carpenter, J, Boulos, A, Jindal, G, Puri, AS, Chitale, R, Deshaies, EM, Robinson, DH, Kallmes, DF, Baxter, BW, Jumaa, MA, Sunenshine, P, Majjhoo, A, English, JD, Suzuki, S, Fessler, RD, Almandoz, JED, Martin, JC & Haussen, DC 2017, 'Systematic evaluation of patients treated with neurothrombectomy devices for acute ischemic stroke primary results of the STRATIS registry', Stroke, vol. 48, no. 10, pp. 2760-2768. https://doi.org/10.1161/STROKEAHA.117.016456

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title = "Systematic evaluation of patients treated with neurothrombectomy devices for acute ischemic stroke primary results of the STRATIS registry",

abstract = "Background and Purpose-Mechanical thrombectomy with stent retrievers has become standard of care for treatment of acute ischemic stroke patients because of large vessel occlusion. The STRATIS registry (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke) aimed to assess whether similar process timelines, technical, and functional outcomes could be achieved in a large real world cohort as in the randomized trials. Methods-STRATIS was designed to prospectively enroll patients treated in the United States with a Solitaire Revascularization Device and Mindframe Capture Low Profile Revascularization Device within 8 hours from symptom onset. The STRATIS cohort was compared with the interventional cohort of a previously published SEER patient-level meta-analysis. Results-A total of 984 patients treated at 55 sites were analyzed. The mean National Institutes of Health Stroke Scale score was 17.3. Intravenous tissue-type plasminogen activator was administered in 64.0%. The median time from onset to arrival in the enrolling hospital, door to puncture, and puncture to reperfusion were 138, 72, and 36 minutes, respectively. The Core lab-adjudicated modified Thrombolysis in Cerebral Infarction ≥2b was achieved in 87.9% of patients. At 90 days, 56.5% achieved a modified Rankin Scale score of 0 to 2, all-cause mortality was 14.4%, and 1.4% suffered a symptomatic intracranial hemorrhage. The median time from emergency medical services scene arrival to puncture was 152 minutes, and each hour delay in this interval was associated with a 5.5% absolute decline in the likelihood of achieving modified Rankin Scale score 0 to 2. Conclusions-This largest-to-date Solitaire registry documents that the results of the randomized trials can be reproduced in the community. The decrease of clinical benefit over time warrants optimization of the system of care.",

keywords = "Ischemic stroke, Mindframe capture, Registry, Solitaire, Stent, System of care, Thrombectomy",

author = "Mueller-Kronast, {Nils H.} and Zaidat, {Osama O.} and Froehler, {Michael T.} and Reza Jahan and Aziz-Sultan, {Mohammad Ali} and Klucznik, {Richard P.} and Saver, {Jeffrey L.} and Hellinger, {Frank R.} and Yavagal, {Dileep R.} and Yao, {Tom L.} and Liebeskind, {David S.} and Jadhav, {Ashutosh P.} and Rishi Gupta and Hassan, {Ameer E.} and Martin, {Coleman O.} and Hormozd Bozorgchami and Ritesh Kaushal and Nogueira, {Raul G.} and Gandhi, {Ravi H.} and Peterson, {Eric C.} and Dashti, {Shervin R.} and Given, {Curtis A.} and Mehta, {Brijesh P.} and Vivek Deshmukh and Sidney Starkman and Italo Linfante and McPherson, {Scott H.} and Peter Kvamme and Grobelny, {Thomas J.} and Hussain, {Muhammad S.} and Ike Thacker and Nirav Vora and Chen, {Peng Roc} and Monteith, {Stephen J.} and Ecker, {Robert D.} and Schirmer, {Clemens M.} and Eric Sauvageau and Alex Abou-Chebl and Derdeyn, {Colin P.} and Lucian Maidan and Aamir Badruddin and Siddiqui, {Adnan H.} and Dumont, {Travis M.} and Abdulnasser Alhajeri and Taqi, {M. Asif} and Khaled Asi and Jeffrey Carpenter and Alan Boulos and Gaurav Jindal and Puri, {Ajit S.} and Rohan Chitale and Deshaies, {Eric M.} and Robinson, {David H.} and Kallmes, {David F.} and Baxter, {Blaise W.} and Jumaa, {Mouhammad A.} and Peter Sunenshine and Aniel Majjhoo and English, {Joey D.} and Shuichi Suzuki and Fessler, {Richard D.} and Almandoz, {Josser E.Delgado} and Martin, {Jerry C.} and Haussen, {Diogo C.}",

note = "Publisher Copyright: {\textcopyright} 2017 American Heart Association, Inc.",

year = "2017",

month = oct,

doi = "10.1161/STROKEAHA.117.016456",

language = "English (US)",

volume = "48",

pages = "2760--2768",

journal = "Stroke",

issn = "0039-2499",

publisher = "Lippincott Williams and Wilkins",

number = "10",

}

TY - JOUR

T1 - Systematic evaluation of patients treated with neurothrombectomy devices for acute ischemic stroke primary results of the STRATIS registry

AU - Mueller-Kronast, Nils H.

AU - Zaidat, Osama O.

AU - Froehler, Michael T.

AU - Jahan, Reza

AU - Aziz-Sultan, Mohammad Ali

AU - Klucznik, Richard P.

AU - Saver, Jeffrey L.

AU - Hellinger, Frank R.

AU - Yavagal, Dileep R.

AU - Yao, Tom L.

AU - Liebeskind, David S.

AU - Jadhav, Ashutosh P.

AU - Gupta, Rishi

AU - Hassan, Ameer E.

AU - Martin, Coleman O.

AU - Bozorgchami, Hormozd

AU - Kaushal, Ritesh

AU - Nogueira, Raul G.

AU - Gandhi, Ravi H.

AU - Peterson, Eric C.

AU - Dashti, Shervin R.

AU - Given, Curtis A.

AU - Mehta, Brijesh P.

AU - Deshmukh, Vivek

AU - Starkman, Sidney

AU - Linfante, Italo

AU - McPherson, Scott H.

AU - Kvamme, Peter

AU - Grobelny, Thomas J.

AU - Hussain, Muhammad S.

AU - Thacker, Ike

AU - Vora, Nirav

AU - Chen, Peng Roc

AU - Monteith, Stephen J.

AU - Ecker, Robert D.

AU - Schirmer, Clemens M.

AU - Sauvageau, Eric

AU - Abou-Chebl, Alex

AU - Derdeyn, Colin P.

AU - Maidan, Lucian

AU - Badruddin, Aamir

AU - Siddiqui, Adnan H.

AU - Dumont, Travis M.

AU - Alhajeri, Abdulnasser

AU - Taqi, M. Asif

AU - Asi, Khaled

AU - Carpenter, Jeffrey

AU - Boulos, Alan

AU - Jindal, Gaurav

AU - Puri, Ajit S.

AU - Chitale, Rohan

AU - Deshaies, Eric M.

AU - Robinson, David H.

AU - Kallmes, David F.

AU - Baxter, Blaise W.

AU - Jumaa, Mouhammad A.

AU - Sunenshine, Peter

AU - Majjhoo, Aniel

AU - English, Joey D.

AU - Suzuki, Shuichi

AU - Fessler, Richard D.

AU - Almandoz, Josser E.Delgado

AU - Martin, Jerry C.

AU - Haussen, Diogo C.

PY - 2017/10

Y1 - 2017/10

N2 - Background and Purpose-Mechanical thrombectomy with stent retrievers has become standard of care for treatment of acute ischemic stroke patients because of large vessel occlusion. The STRATIS registry (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke) aimed to assess whether similar process timelines, technical, and functional outcomes could be achieved in a large real world cohort as in the randomized trials. Methods-STRATIS was designed to prospectively enroll patients treated in the United States with a Solitaire Revascularization Device and Mindframe Capture Low Profile Revascularization Device within 8 hours from symptom onset. The STRATIS cohort was compared with the interventional cohort of a previously published SEER patient-level meta-analysis. Results-A total of 984 patients treated at 55 sites were analyzed. The mean National Institutes of Health Stroke Scale score was 17.3. Intravenous tissue-type plasminogen activator was administered in 64.0%. The median time from onset to arrival in the enrolling hospital, door to puncture, and puncture to reperfusion were 138, 72, and 36 minutes, respectively. The Core lab-adjudicated modified Thrombolysis in Cerebral Infarction ≥2b was achieved in 87.9% of patients. At 90 days, 56.5% achieved a modified Rankin Scale score of 0 to 2, all-cause mortality was 14.4%, and 1.4% suffered a symptomatic intracranial hemorrhage. The median time from emergency medical services scene arrival to puncture was 152 minutes, and each hour delay in this interval was associated with a 5.5% absolute decline in the likelihood of achieving modified Rankin Scale score 0 to 2. Conclusions-This largest-to-date Solitaire registry documents that the results of the randomized trials can be reproduced in the community. The decrease of clinical benefit over time warrants optimization of the system of care.

AB - Background and Purpose-Mechanical thrombectomy with stent retrievers has become standard of care for treatment of acute ischemic stroke patients because of large vessel occlusion. The STRATIS registry (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke) aimed to assess whether similar process timelines, technical, and functional outcomes could be achieved in a large real world cohort as in the randomized trials. Methods-STRATIS was designed to prospectively enroll patients treated in the United States with a Solitaire Revascularization Device and Mindframe Capture Low Profile Revascularization Device within 8 hours from symptom onset. The STRATIS cohort was compared with the interventional cohort of a previously published SEER patient-level meta-analysis. Results-A total of 984 patients treated at 55 sites were analyzed. The mean National Institutes of Health Stroke Scale score was 17.3. Intravenous tissue-type plasminogen activator was administered in 64.0%. The median time from onset to arrival in the enrolling hospital, door to puncture, and puncture to reperfusion were 138, 72, and 36 minutes, respectively. The Core lab-adjudicated modified Thrombolysis in Cerebral Infarction ≥2b was achieved in 87.9% of patients. At 90 days, 56.5% achieved a modified Rankin Scale score of 0 to 2, all-cause mortality was 14.4%, and 1.4% suffered a symptomatic intracranial hemorrhage. The median time from emergency medical services scene arrival to puncture was 152 minutes, and each hour delay in this interval was associated with a 5.5% absolute decline in the likelihood of achieving modified Rankin Scale score 0 to 2. Conclusions-This largest-to-date Solitaire registry documents that the results of the randomized trials can be reproduced in the community. The decrease of clinical benefit over time warrants optimization of the system of care.

KW - Ischemic stroke

KW - Mindframe capture

KW - Registry

KW - Solitaire

KW - Stent

KW - System of care

KW - Thrombectomy

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SN - 0039-2499

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JO - Stroke

JF - Stroke

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ER -

Systematic evaluation of patients treated with neurothrombectomy devices for acute ischemic stroke primary results of the STRATIS registry

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