Evidence map›Paper›PMID 39179880›Full record

ArticleClinical neuroradiology2025

Trevo 3 Mm and/or AXS Catalyst 5 for the Treatment of Medium Distal Vessel Occlusion Stroke-results from the ASSIST Registry.

Nikolaos Ntoulias, Alex Brehm, Salvador Miralbés, Bharath Naravetla, Alejandro Spiotta, Christian Loehr, Mario Martínez-Galdámez, Ryan McTaggart, Luc Defreyne, Pedro Vega and 7 more

Abstract readMulticenter Study
In one paragraph

Article in Clinical neuroradiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Nikolaos NtouliasDiagnostic and Interventional Neuroradiology, University Hospital Basel, Basel, Switzerland.
Alex BrehmDiagnostic and Interventional Neuroradiology, University Hospital Basel, Basel, Switzerland.
Salvador MiralbésNeuroradiology, Hospital Son Espases, Mallorca, Spain.
Bharath NaravetlaInterventional Neurology, McLaren Regional Medical Center, Flint, MI, USA.
Alejandro SpiottaNeurosurgery, Medical University of South Carolina, Charleston, SC, USA.
Christian LoehrRadiology and Neuroradiology, Klinikum Vest Recklinghausen, Recklinghausen, Germany.
Mario Martínez-GaldámezInterventional Neuroradiology/Endovascular Neurosurgery, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
Ryan McTaggartInterventional Neuroradiology, Rhode Island Hospital, Providence, RI, USA.
Luc DefreyneVascular and Interventional Radiology, Ghent University Hospital, Ghent, Belgium.
Pedro VegaRadiology, Hospital Universitario Central de Asturias-HUCA, Oviedo, Spain.
Osama O Zaidateuroscience Department, Bon Secours Mercy Health St. Vincent Medical Center, Toledo, OH, USA.
Lori Lyn PriceStryker Neurovascular, Fremont, CA, USA.
David S LiebeskindDepartment of Neurology and Comprehensive Stroke Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
Markus MöhlenbruchNeuroradiology, Uniklinik Heidelberg, Heidelberg, Germany.
Rishi GuptaWellstar Medical Group, Neurosurgery, WellStar Health System, Marietta, GA, USA.
Marios-Nikos PsychogiosDiagnostic and Interventional Neuroradiology, University Hospital Basel, Basel, Switzerland. Marios.psychogios@usb.ch.ORCID http://orcid.org/0000-0002-0016-414X
ASSIST Investigator

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe effect of endovascular therapy (EVT) on the outcome of stroke patients with a medium distal vessel occlusion (MDVO) is unclear. We report the results of MDVO patients treated with the 3 mm Trevo stent retriever (SR) and/or the AXS Catalyst 5 distal access catheter.

methodsData was derived from a prospective, multicenter global registry (ASSIST registry) which enrolled patients treated with operator preferred EVT technique at 71 sites from January 2019 to January 2022. Three techniques were assessed: SR classic, direct aspiration, and a combined approach. Additional inclusion criteria were (a) EVT performed with the 3 mm Trevo SR and/or AXS Catalyst 5 distal access catheter on the first pass and (b) an occlusion of the M2 segment or M3 segment of the middle cerebral artery or the A1, A2 or A3 segment of the anterior cerebral artery. The primary outcome was achieving an expanded Thrombolysis in Cerebral Infarction (eTICI) score of 2c or 3 on the first pass, with the primary technique as adjudicated by core lab. The primary clinical outcome measure was a 90-day modified Rankin Scale (mRS) score of 0-2.

resultsA total of 155 patients (10.4% of the ASSIST population) were included. Most patients had an M2 occlusion (93.5%). First pass eTICI reperfusion was achieved in 43.1% of the patients. No modifying effect of the frontline technique was found. The rate of mRS 0-2 (overall 65.0%) did not significantly differ between groups.

conclusionThe data suggests that the Trevo 3 mm SR and/or the AXS Catalyst 5 may be an option to treat medium distal vessel occlusion, but more data is needed to demonstrate safety and efficacy in this patient cohort. Further improvements are needed regarding materials and techniques to improve reperfusion results in this patient cohort in the future.

Indexed as

Endovascular ProceduresInfarction, Middle Cerebral ArteryIschemic StrokeStentsStrokeThrombectomyAgedAged, 80 and overFemaleHumansMaleMiddle AgedProspective StudiesRegistriesTreatment OutcomeDistal vessel occlusionEndovascular therapyIschemic strokeMechanical thrombectomyMedium vessel occlusion

Identifiers

PMID39179880
PMCPMC11832688

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.