pRESET thrombectomy device outcomes in patients with acute ischemic stroke: A systematic review and meta-analysis

Abstract

Background

Many devices are used to perform mechanical thrombectomy in the setting of large vessel occlusion acute ischemic stroke. We sought to evaluate the efficacy and safety of pRESET stent-retriever systems.

Methods

We conducted a comprehensive systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Relevant studies up to March 2024 were retrieved from PubMed, Scopus, Web of Science, and Embase databases.

Results

A total of 8 papers met the inclusion/exclusion criteria comprising a total of 1140 participants (average age 72.4 ± 11.9, female percentage (50%). Preintervention intravenous thrombolysis was utilized in 46.5% (range 32.9–65.4) of patients, with a median National Institute of Health Stroke Scale at presentation of 15 (range 0–38). The middle cerebral artery was the most commonly affected artery, with a prevalence of 76.4% (range 62.8–100). The pRESET stent-retriever systems demonstrated a first-passing effect rate of 53.4% [95% confidence interval [CI] 44.8; 61.7] and a final thrombolysis in cerebral infarction 2b-3 grade rate of 90.41% [95% CI 82.13; 95.08]. Ninety-day modified Rankin Scale (0–2) rate was 42.2% [95% CI 27.6; 58.4], and 90-day mortality rate was 15.1% [95% CI 9.8; 22.6]. Postintervention hemorrhage occurred at a rate of 28.6% [CI 17.2; 43.6].

Conclusion

Our systematic review and meta-analysis describes the efficacy of the pRESET stent retriever system in managing acute ischemic stroke patients. The pRESET device was found to have a similar safety and efficacy profile to other mechanical thrombectomy devices currently in use.

Keywords

Ischemic stroke pRESET endovascular thrombectomy stent retriever

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References

Paley

Williamson

Bray

, et al. Associations between 30-day mortality, specialist nursing, and daily physician ward rounds in a national stroke registry. Stroke 2018; 49: 2155–2162.

Benjamin

Virani

Callaway

, et al. Heart disease and stroke statistics—2018 update: a report from the American Heart Association. Circulation 2018; 137: e67–e492.

Yousufuddin

Young

. Aging and ischemic stroke. Aging (Albany NY) 2019; 11: 2542–2544.

Yan

Chen

, et al. Prevention, management, and rehabilitation of stroke in low- and middle-income countries. eNeurologicalSci 2016; 2: 21–30.

Kidwell

Jahan

Gornbein

, et al. A trial of imaging selection and endovascular treatment for ischemic stroke. N Engl J Med 2013; 368: 914–923.

Broderick

Tomsick

Palesch

. Endovascular treatment for acute ischemic stroke. N Engl J Med 2013; 368: 2432–2433.

Ciccone

Valvassori

Nichelatti

, et al. Endovascular treatment for acute ischemic stroke. N Engl J Med 2013; 368: 904–913.

Jahan

. Solitaire flow-restoration device for treatment of acute ischemic stroke: safety and recanalization efficacy study in a swine vessel occlusion model. AJNR Am J Neuroradiol 2010; 31: 1938–1943.

Nogueira

Lutsep

Gupta

, et al. Trevo versus merci retrievers for thrombectomy revascularisation of large vessel occlusions in acute ischaemic stroke (TREVO 2): a randomised trial. Lancet 2012; 380: 1231–1240.

10.

Chueh

Marosfoi

Brooks

, et al. Novel distal emboli protection technology: the EmboTrap. Interv Neurol 2017; 6: 268–276.

11.

Lambrinos

Schaink

Dhalla

, et al. Mechanical thrombectomy in acute ischemic stroke: a systematic review. Can J Neurol Sci 2016; 43: 455–460.

12.

Powers

Derdeyn

Biller

, et al. 2015 American Heart Association/American Stroke Association focused update of the 2013 guidelines for the early management of patients with acute ischemic stroke regarding endovascular treatment: a guideline for healthcare professionals from the American Heart Association/American stroke association. Stroke 2015; 46: 3020–3035.

13.

Kurre

Aguilar-Pérez

Schmid

, et al. Clinical experience with the pRESET stent retriever for the treatment of acute ischemic stroke—a review of 271 consecutive cases. Neuroradiology 2014; 56: 397–403.

14.

Mordasini

Brekenfeld

Byrne

, et al. Experimental evaluation of immediate recanalization effect and recanalization efficacy of a new thrombus retriever for acute stroke treatment in vivo. AJNR Am J Neuroradiol 2013; 34: 153–158.

15.

Schwaiger

Kober

Gersing

, et al. The pRESET stent retriever for endovascular treatment of stroke caused by MCA occlusion: safety and clinical outcome. Clin Neuroradiol 2016; 26: 47–55.

16.

Page

McKenzie

Bossuyt

, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Br Med J 2021; 372: 71.

17.

Sterne

Hernán

Reeves

, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. Br Med J 2016; 355: i4919.

18.

Sterne

JAC

Savović

Page

, et al. Rob 2: a revised tool for assessing risk of bias in randomised trials. Br Med J 2019; 366: l4898.

19.

Schwarzer

. Meta: an R package for meta-analysis. R News 2007; 7: 40–45.

20.

Deeks

Higgins

Altman

and Group obotCSM , etal. Analysing data and undertaking meta-analyses. In: Cochrane handbook for systematic reviews of interventions. John Wiley & Sons, 2019, pp.241–284.

21.

Phenox. Phenox. Wallaby medical company, 2024.

22.

Jovin

Chamorro

Cobo

, et al. Thrombectomy within 8 h after symptom onset in ischemic stroke. N Engl J Med 2015; 372: 2296–2306.

23.

Campbell

Mitchell

Kleinig

, et al. Endovascular therapy for ischemic stroke with perfusion-imaging selection. N Engl J Med 2015; 372: 1009–1018.

24.

Berkhemer

Fransen

Beumer

, et al. A randomized trial of intraarterial treatment for acute ischemic stroke. N Engl J Med 2015; 372: 11–20.

25.

Goyal

Demchuk

Menon

, et al. Randomized assessment of rapid endovascular treatment of ischemic stroke. N Engl J Med 2015; 372: 1019–1030.

26.

Saver

Goyal

Bonafe

, et al. Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke. N Engl J Med 2015; 372: 2285–2295.

27.

Raha

Hall

Malik

, et al. Advances in mechanical thrombectomy for acute ischaemic stroke. BMJ Med 2023; 2: e000407.

28.

Nogueira

Jadhav

Haussen

, et al. Thrombectomy 6 to 24 hours after stroke with a mismatch between deficit and infarct. N Engl J Med 2018; 378: 11–21.

29.

Shaban

Al Kasab

Chalhoub

, et al. Mechanical thrombectomy for large vessel occlusion strokes beyond 24 h. J Neurointerv Surg 2023; 15: e331–e3e6.

30.

Gory

Mazighi

Labreuche

, et al. Predictors for mortality after mechanical thrombectomy of acute basilar artery occlusion. Cerebrovasc Dis 2018; 45: 61–67.

31.

Awad

Kilburg

Ravindra

, et al. Predicting death after thrombectomy in the treatment of acute stroke. Front Surg 2020; 7: 16.

32.

Ozkara

Karabacak

Kotha

, et al. Prediction of poor outcome after successful thrombectomy in patients with severe acute ischemic stroke: a pilot retrospective study. Neurol Int 2023; 15: 225–237.

33.

Zaidat

Ikeme

Sheth

, et al. MASTRO I: meta-analysis and systematic review of thrombectomy stent retriever outcomes: comparing functional, safety and recanalization outcomes between EmboTrap, Solitaire and Trevo in acute ischemic stroke. J Comp Eff Res 2023; 12: e230001.

34.

Nogueira

Lobsien

Klisch

, et al. Thrombectomy with the pRESET vs solitaire stent retrievers as first-line large vessel occlusion stroke treatment: a randomized clinical trial. JAMA Neurol 2024; 81: 170–178.

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