Comparison of the Tigertriever and Self-expanding Stent Retrievers for Mechanical Thrombectomy of Acute Ischemic Stroke: A Single-center Experience

Stent retrievers, including the novel Tigertriever, are important in mechanical thrombectomy for acute ischemic stroke due to a proximal large-vessel occlusion within the anterior circulation. We aimed to assess the efficacy and safety of the Tigertriever compared to self-expanding stent retrievers...

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Main Authors: Koichiro SHINDO, Kazutaka UCHIDA, Manabu SHIRAKAWA, Shoichiro TSUJI, Shuntaro KUWAHARA, Yoji KURAMOTO, Shinichi YOSHIMURA
Format: Article
Language:English
Published: The Japan Neurosurgical Society 2025-05-01
Series:Neurologia Medico-Chirurgica
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Online Access:https://www.jstage.jst.go.jp/article/nmc/65/5/65_2024-0297/_pdf/-char/en
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author Koichiro SHINDO
Kazutaka UCHIDA
Manabu SHIRAKAWA
Shoichiro TSUJI
Shuntaro KUWAHARA
Yoji KURAMOTO
Shinichi YOSHIMURA
author_facet Koichiro SHINDO
Kazutaka UCHIDA
Manabu SHIRAKAWA
Shoichiro TSUJI
Shuntaro KUWAHARA
Yoji KURAMOTO
Shinichi YOSHIMURA
author_sort Koichiro SHINDO
collection DOAJ
description Stent retrievers, including the novel Tigertriever, are important in mechanical thrombectomy for acute ischemic stroke due to a proximal large-vessel occlusion within the anterior circulation. We aimed to assess the efficacy and safety of the Tigertriever compared to self-expanding stent retrievers like EmboTrap, Solitaire, Trevo, or Tron. Patients treated at a stroke center for intracranial vessel occlusion in the anterior circulation between August 2022 and August 2024 were evaluated. The primary outcome was a modified first-pass effect, defined as a modified thrombolysis in cerebral infarction grade of 2b-3 after the first pass. Secondary outcomes included the first-pass effect, device-related serious adverse events, embolization in new territory, and hemorrhagic complications within 24 hours post-procedure. Data from 104 hemispheres in 103 patients were analyzed (24 in the Tigertriever group and 80 in the stent-retriever group). The Tigertriever group demonstrated a higher modified first-pass effect (70.8% vs. 52.5%; adjusted odds ratio 3.17; 95% confidence interval 1.06-9.47; p = 0.02). Although not statistically significant, vessel dissection (0% vs. 3.8%), subarachnoid hemorrhage (20.8% vs. 32.5%), and symptomatic intracranial hemorrhage (4.2% vs. 12.5%) within 24 hours post-procedure were lower in the Tigertriever group. No significant differences were observed in the first-pass effect or embolization in the new territory between the 2 groups. The Tigertriever might be effective for anterior circulation intracranial vessel occlusion, achieving a higher rate of modified first-pass effect. It might also be associated with minimal serious procedural complications, indicating its safety profile.
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publishDate 2025-05-01
publisher The Japan Neurosurgical Society
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series Neurologia Medico-Chirurgica
spelling doaj-art-df87ee580a3f44a5b3c68d67cb7fddbc2025-08-20T02:03:16ZengThe Japan Neurosurgical SocietyNeurologia Medico-Chirurgica1349-80292025-05-0165524725410.2176/jns-nmc.2024-02972024-0297Comparison of the Tigertriever and Self-expanding Stent Retrievers for Mechanical Thrombectomy of Acute Ischemic Stroke: A Single-center ExperienceKoichiro SHINDO0Kazutaka UCHIDA1Manabu SHIRAKAWA2Shoichiro TSUJI3Shuntaro KUWAHARA4Yoji KURAMOTO5Shinichi YOSHIMURA6Department of Neurosurgery, Hyogo Medical UniversityDepartment of Neurosurgery, Hyogo Medical UniversityDepartment of Neurosurgery, Hyogo Medical UniversityDepartment of Neurosurgery, Hyogo Medical UniversityDepartment of Neurosurgery, Hyogo Medical UniversityDepartment of Neurosurgery, Hyogo Medical UniversityDepartment of Neurosurgery, Hyogo Medical UniversityStent retrievers, including the novel Tigertriever, are important in mechanical thrombectomy for acute ischemic stroke due to a proximal large-vessel occlusion within the anterior circulation. We aimed to assess the efficacy and safety of the Tigertriever compared to self-expanding stent retrievers like EmboTrap, Solitaire, Trevo, or Tron. Patients treated at a stroke center for intracranial vessel occlusion in the anterior circulation between August 2022 and August 2024 were evaluated. The primary outcome was a modified first-pass effect, defined as a modified thrombolysis in cerebral infarction grade of 2b-3 after the first pass. Secondary outcomes included the first-pass effect, device-related serious adverse events, embolization in new territory, and hemorrhagic complications within 24 hours post-procedure. Data from 104 hemispheres in 103 patients were analyzed (24 in the Tigertriever group and 80 in the stent-retriever group). The Tigertriever group demonstrated a higher modified first-pass effect (70.8% vs. 52.5%; adjusted odds ratio 3.17; 95% confidence interval 1.06-9.47; p = 0.02). Although not statistically significant, vessel dissection (0% vs. 3.8%), subarachnoid hemorrhage (20.8% vs. 32.5%), and symptomatic intracranial hemorrhage (4.2% vs. 12.5%) within 24 hours post-procedure were lower in the Tigertriever group. No significant differences were observed in the first-pass effect or embolization in the new territory between the 2 groups. The Tigertriever might be effective for anterior circulation intracranial vessel occlusion, achieving a higher rate of modified first-pass effect. It might also be associated with minimal serious procedural complications, indicating its safety profile.https://www.jstage.jst.go.jp/article/nmc/65/5/65_2024-0297/_pdf/-char/enacute ischemic strokelarge-vessel occlusionstent-retrievermanually adjustable tigertrieverrecanalization rate
spellingShingle Koichiro SHINDO
Kazutaka UCHIDA
Manabu SHIRAKAWA
Shoichiro TSUJI
Shuntaro KUWAHARA
Yoji KURAMOTO
Shinichi YOSHIMURA
Comparison of the Tigertriever and Self-expanding Stent Retrievers for Mechanical Thrombectomy of Acute Ischemic Stroke: A Single-center Experience
Neurologia Medico-Chirurgica
acute ischemic stroke
large-vessel occlusion
stent-retriever
manually adjustable tigertriever
recanalization rate
title Comparison of the Tigertriever and Self-expanding Stent Retrievers for Mechanical Thrombectomy of Acute Ischemic Stroke: A Single-center Experience
title_full Comparison of the Tigertriever and Self-expanding Stent Retrievers for Mechanical Thrombectomy of Acute Ischemic Stroke: A Single-center Experience
title_fullStr Comparison of the Tigertriever and Self-expanding Stent Retrievers for Mechanical Thrombectomy of Acute Ischemic Stroke: A Single-center Experience
title_full_unstemmed Comparison of the Tigertriever and Self-expanding Stent Retrievers for Mechanical Thrombectomy of Acute Ischemic Stroke: A Single-center Experience
title_short Comparison of the Tigertriever and Self-expanding Stent Retrievers for Mechanical Thrombectomy of Acute Ischemic Stroke: A Single-center Experience
title_sort comparison of the tigertriever and self expanding stent retrievers for mechanical thrombectomy of acute ischemic stroke a single center experience
topic acute ischemic stroke
large-vessel occlusion
stent-retriever
manually adjustable tigertriever
recanalization rate
url https://www.jstage.jst.go.jp/article/nmc/65/5/65_2024-0297/_pdf/-char/en
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