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Research ArticleNeurointervention

Early Postmarket Results with EmboTrap II Stent Retriever for Mechanical Thrombectomy: A Multicenter Experience

A. Srivatsan, V.M. Srinivasan, R.M. Starke, E.C. Peterson, D.R. Yavagal, A.E. Hassan, A. Alawieh, A.M. Spiotta, Y. Saleem, K.M. Fargen, S.Q. Wolfe, R.A. de Leacy, I.P. Singh, I.L. Maier, J.N. Johnson, J.-K. Burkhardt, S.R. Chen and P. Kan
American Journal of Neuroradiology May 2021, 42 (5) 904-909; DOI: https://doi.org/10.3174/ajnr.A7067
A. Srivatsan
aFrom the Department of Neurosurgery and Neurology (A.S., V.M.S., Y.S., J.N.J., J.-K.B., P.K.), Baylor College of Medicine, Houston, Texas
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V.M. Srinivasan
aFrom the Department of Neurosurgery and Neurology (A.S., V.M.S., Y.S., J.N.J., J.-K.B., P.K.), Baylor College of Medicine, Houston, Texas
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R.M. Starke
bDepartment of Neurosurgery (R.M.S., E.C.P., D.R.Y.), University of Miami Miller School of Medicine, Miami, Florida
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E.C. Peterson
bDepartment of Neurosurgery (R.M.S., E.C.P., D.R.Y.), University of Miami Miller School of Medicine, Miami, Florida
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D.R. Yavagal
bDepartment of Neurosurgery (R.M.S., E.C.P., D.R.Y.), University of Miami Miller School of Medicine, Miami, Florida
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A.E. Hassan
cDepartment of Neurology and Radiology (A.E.H.), University of Texas Health Science Center San Antonio, San Antonio, Texas
dDepartment of Neurology (A.E.H.), University of Texas Rio Grande Valley, Harlingen, Texas
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A. Alawieh
eDepartment of Neurosurgery (A.A., A.M.S.), Medical University of South Carolina, Charleston, South Carolina
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A.M. Spiotta
eDepartment of Neurosurgery (A.A., A.M.S.), Medical University of South Carolina, Charleston, South Carolina
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Y. Saleem
aFrom the Department of Neurosurgery and Neurology (A.S., V.M.S., Y.S., J.N.J., J.-K.B., P.K.), Baylor College of Medicine, Houston, Texas
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K.M. Fargen
fDepartment of Neurosurgery (K.M.F., S.Q.W.), Wake Forest University School of Medicine, Winston-Salem, North Carolina
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S.Q. Wolfe
fDepartment of Neurosurgery (K.M.F., S.Q.W.), Wake Forest University School of Medicine, Winston-Salem, North Carolina
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R.A. de Leacy
gDepartment of Neurosurgery (R.A.d.L., I.P.S.), Mt. Sinai Icahn School of Medicine, New York, New York
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I.P. Singh
gDepartment of Neurosurgery (R.A.d.L., I.P.S.), Mt. Sinai Icahn School of Medicine, New York, New York
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I.L. Maier
hDepartment of Neurology (I.L.M.), University Medical Center Göttingen, Göttingen, Germany
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J.N. Johnson
aFrom the Department of Neurosurgery and Neurology (A.S., V.M.S., Y.S., J.N.J., J.-K.B., P.K.), Baylor College of Medicine, Houston, Texas
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J.-K. Burkhardt
aFrom the Department of Neurosurgery and Neurology (A.S., V.M.S., Y.S., J.N.J., J.-K.B., P.K.), Baylor College of Medicine, Houston, Texas
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S.R. Chen
iDepartment of Interventional Radiology (S.R.C.), MD Anderson Cancer Center, Houston, Texas.
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P. Kan
aFrom the Department of Neurosurgery and Neurology (A.S., V.M.S., Y.S., J.N.J., J.-K.B., P.K.), Baylor College of Medicine, Houston, Texas
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Abstract

BACKGROUND AND PURPOSE: EmboTrap II is a novel stent retriever with a dual-layer design and distal mesh designed for acute ischemic stroke emergent large-vessel occlusions. We present the first postmarket prospective multicenter experience with the EmboTrap II stent retriever.

MATERIALS AND METHODS: A prospective registry of patients treated with EmboTrap II at 7 centers following FDA approval was maintained with baseline patient characteristics, treatment details, and clinical/radiographic follow-up.

RESULTS: Seventy patients were treated with EmboTrap II (mean age, 69.9 years; 48.6% women). Intravenous thrombolysis was given in 34.3%, and emergent large-vessel occlusions were located in the ICA (n = 18), M1 (n = 38), M2 or M3 (n = 13), and basilar artery (n = 1). The 5 × 33 mm device was used in 88% of cases. TICI ≥ 2b recanalization was achieved in 95.7% (82.3% in EmboTrap II–only cases), and first-pass efficacy was achieved in 35.7%. The NIHSS score improved from a preoperative average of 16.3 to 12.1 postprocedure and to 10.5 at discharge. An average of 2.5 [SD, 1.8] passes was recorded per treatment, including non-EmboTrap attempts. Definitive treatment was performed with an alternative device (aspiration or stent retriever) in 9 cases (12.9%). Some hemorrhagic conversion was noted in 22.9% of cases, of which 4.3% were symptomatic. There were no device-related complications.

CONCLUSIONS: Initial postmarket results with the EmboTrap II stent retriever are favorable and comparable with those of other commercially available stent retrievers. Compared with EmboTrap II, the first-generation EmboTrap may have a higher first-pass efficacy; however, data are limited by retrospective case analysis, incomplete clinical follow-up, and small sample size, necessitating future trials.

ABBREVIATIONS:

AIS
acute ischemic stroke
BGC
balloon-guide catheter
FPE
first-pass efficacy
LKN
last known healthy
sICH
symptomatic intracerebral hemorrhage
  • © 2021 by American Journal of Neuroradiology
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American Journal of Neuroradiology: 42 (5)
American Journal of Neuroradiology
Vol. 42, Issue 5
1 May 2021
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Cite this article
A. Srivatsan, V.M. Srinivasan, R.M. Starke, E.C. Peterson, D.R. Yavagal, A.E. Hassan, A. Alawieh, A.M. Spiotta, Y. Saleem, K.M. Fargen, S.Q. Wolfe, R.A. de Leacy, I.P. Singh, I.L. Maier, J.N. Johnson, J.-K. Burkhardt, S.R. Chen, P. Kan
Early Postmarket Results with EmboTrap II Stent Retriever for Mechanical Thrombectomy: A Multicenter Experience
American Journal of Neuroradiology May 2021, 42 (5) 904-909; DOI: 10.3174/ajnr.A7067

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Early Postmarket Results with EmboTrap II Stent Retriever for Mechanical Thrombectomy: A Multicenter Experience
A. Srivatsan, V.M. Srinivasan, R.M. Starke, E.C. Peterson, D.R. Yavagal, A.E. Hassan, A. Alawieh, A.M. Spiotta, Y. Saleem, K.M. Fargen, S.Q. Wolfe, R.A. de Leacy, I.P. Singh, I.L. Maier, J.N. Johnson, J.-K. Burkhardt, S.R. Chen, P. Kan
American Journal of Neuroradiology May 2021, 42 (5) 904-909; DOI: 10.3174/ajnr.A7067
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