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Luo G, Yan X, Xiao G, Wei L, Nai Bi Jiang YLK, Ma R, Chen W, Fang C, Zhou Z, Wan J, Peng Y, Zhang G, Zhao J, Li L, Yuan H, Wu J, Li B, Zhang F, Cheng Y, Gao F, Miao Z. Comparing a novel Catfish flow restoration device and the Solitaire stent retriever for thrombectomy revascularisation in emergent largevessel occlusion stroke: a prospective randomised controlled study. Stroke Vasc Neurol 2023; 8:435-443. [PMID: 37045544 PMCID: PMC10800261 DOI: 10.1136/svn-2022-002036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 02/26/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND The Catfish stent retriever is a newly developed mechanical thrombectomy device for rapid recanalisation in emergent large vessel occlusion (ELVO) stroke. The current trial aimed to assess whether the Catfish stent retriever is non-inferior to the Solitaire stent retriever in terms of outcomes in ELVO stroke. METHODS This was a randomised, prospective, parallel-group, multicentre, open-label, non-inferiority study conducted at 18 sites in China. The primary outcome was the proportion of cases with successful recanalisation (modified thrombolysis in cerebral infarction score of 2b or 3) following the procedure. Secondary efficacy outcomes included the National Institutes of Health Stroke Scale scores at 24 hours and 7 days or discharge if earlier, time from artery puncture to successful recanalisation and good clinical outcome (modified Rankin scale score ≤2) at 90 days. Safety outcomes included symptomatic intracranial haemorrhage, all cause-death and severe adverse events at 90 days. RESULTS Between 3 March 2019 and 5 June 2021, 118 and 120 patients were randomly allocated to the Catfish and Solitaire groups, respectively. The primary endpoint after all endovascular procedures was non-inferior in the Catfish group (88.5%, 100/113) than in the Solitaire group (87.7%, 100/114), with a rate difference (RD) of 0.78% (95% CI -7.64 to -9.20; p=0.001). Sensitivity analysis only considering the per-protocol set also yielded similar results, with an RD of 0.83% (95% CI -7.03 to -8.70; p<0.001). Additionally, the proportions of cases with good clinical outcomes (47.8% vs 50.0%, p=0.739) and all-cause death rates (17.7% vs 18.8%, p=0.700) were similar in both groups at 90 days. CONCLUSIONS The Catfish stent retriever is an effective and safe device for endovascular recanalisation in ELVO stroke. TRIAL REGISTRATION NUMBER NCT03820882.
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Affiliation(s)
- Gang Luo
- Department of Intervention, Interventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Intervention, Interventional Neuroradiology Center, China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Xiaoyan Yan
- Biostatistics, Peking University Clinical Research Institute, Beijing, China
| | - Guodong Xiao
- Neurology, The Second Affiliated Hospital of Suzhou University, Jiangsu, China
| | - Liping Wei
- Department of Neurology, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, Henan, China
| | | | - Rongyao Ma
- Neurology, Nanshi Hospital of Nanyang, Nanyang, China
| | - Wenhuo Chen
- Neurology, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China
| | - Chun Fang
- Department of Intervention, Tongji Hospital Affiliated to Tongji University, Shanghai, Shanghai, China
| | - Zhiming Zhou
- Department of Intervention, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Jieqing Wan
- Department of Neurosurgery, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, China
| | - Ya Peng
- Department of Neurosurgery, Changzhou No. 1 People's Hospital, Changzhou, China
| | - Guilian Zhang
- Neurology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Junfeng Zhao
- Neurology, Siping Central People's Hospital, Siping, China
| | - Li Li
- Department of Intervention, Xijing Hospital of Air Force Military Medical University, Xi'an, China
| | - Haicheng Yuan
- Neurology, Qingdao Central Medical Group, Qingdao, China
| | - Jin Wu
- Neurology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Bing Li
- Department of Intervention, Qindao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, Shandong, China
| | - Fan Zhang
- Neurology, Hainan General Hospital/Hainan Affiliated Hospital of Hainan Medical University, Hainan, China
| | - Yuhong Cheng
- Department of Intervention, Linfen Central Hospital, Linfen, Shanxi, China
| | - Feng Gao
- Department of Intervention, Interventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Intervention, Interventional Neuroradiology Center, China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Zhongrong Miao
- Department of Intervention, Interventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Intervention, Interventional Neuroradiology Center, China National Clinical Research Center for Neurological Diseases, Beijing, China
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