Moderator of 3 Sessions
Session Description:
Data from the EXCELLENT (Embotrap eXtraction and Clot Evaluation and Lesion evaLuation for NeuroThrombectomy) registry analyzing the characteristics of removed blood clots and how they impacted stroke recovery will be presented. The efficacy of the EMBOTRAP™ III Revascularization Device in a real-world setting will be assessed, as well as to explore correlations between patient comorbidities, clot characteristics, revascularization rates, and clinical outcomes. Learn why the EMBOTRAP design allows for excellent results across the whole scope of clot composition.
Presenter of 9 Presentations
Opening by Chairs
Angels Awards
The History of Thrombolysis From NINDS Trial To Present
Opening words and EXCELLENT Review
Closing by Chairs
Closing by Chairs
Future Leaders Certificates
Opening by Chairs
FINAL ANGIOGRAPHIC, CLINICAL AND THROMBUS COMPOSITION RESULTS OF THE EXCELLENT REGISTRY
Abstract
Background and Aims
EXCELLENT (NCT03685578; Cerenovus) is a large, prospective, international, real-world registry of endovascular clot removal in acute ischemic stroke (AIS) with EmboTrap as the first line mechanical thrombectomy (MT) device, which included collection and analysis of the retrieved thrombus material.
Methods
Between September 2018 and March 2021, 1000 “all-comer” subjects treated per standard of care at each center (with EmboTrap as first line) were enrolled at 36 sites (28US, 6EU, 1UK, 1 Israel). The study employed blind endpoint evaluation, including a core imaging lab and an independent 90-day mRS assessment. Retrieved clot was collected per each MT maneuver from 543 subjects across 26 sites and sent for standardized analysis by independent central labs.
Results
Mean age was 70.0±14.17 years (range 18-102), 51.9% (518/999) subjects were female and 9.8% (98/998) had a pre-stroke mRS 3-5. Baseline NIHSS was 15.6±6.85 (range 0-36); 10.2% (71/696) subjects had a large core (ASPECTS 0-5); 5.0% (49/989) had posterior stroke; 55.2% (528/956) underwent MT ≤6hrs of onset; and 38.0% (380/999) received IV-tPA prior to MT. Key outcomes were first pass eTICI 2c-3=38% (315/827); final 2b-3=94.3% (780/827; median #passes=1); 90-day mRS≤2 or ≤pre-stroke 46.8% (429/916); and 90-day all-cause mortality 19.1% (176/922). In univariate analysis of clot components, high red blood cell and low platelet content were significant predictors of good mRS outcome (p<0.001 and 0.018) and negative predictors of 90-day mortality (p<0.001 and 0.011, respectively).
Conclusions
Final angiographic, clinical and thrombus composition results, along with multivariate analysis of predictors of clinical outcomes, will be presented at the time of the conference.