Abstract 2907: Endostroke-Registry: An International Multicenter Registry for Mechanical Recanalization Procedures in Acute Stroke
Mechanical recanalization prodecures are increasingly used to treat acute large-vessel stroke. High recanalization rates in patients with proximal vessel occlusions and the direct control of therapeutic success are its major strengths. On the other hand, its clinical benefit as well as the risk/benefit ratio are not well defined by now. Randomized trials comparing endovascular approaches with systemic thrombolysis are still ongoing and present-day evidence is based on non-controlled single arm trials and case series. Within the larger studies (Penumbra Pivotal Stroke Trial, MERCI-trials) a discrepancy between favourable angiographic results and poor clinical outcomes was noticeable with high rates (up to 70%) of patients with “futile recanalization”, leading to a “clinical-angiographic mismatch”. Many factors may contribute to this paradox finding, e.g. patient selection bias (inclusion of patients with contraindications for systemic thrombolysis), too long treatment time windows and periprocedural measures (e.g. general anaesthesia). Amongt these, many other factors need clarification before mechanical recanalization therapies can be used in a broader clinical fashion. To adress some of these questions, we launched an international, investigator-driven, multicenter registry (ENDOSTROKE) to accumulate robust data on clinical outcome, complication rates and procedural issues. Its primary main outcome measure is the clinical status 90 days (or later) after intervention assessed by the MRS. Important clinical, angiographic and procedural parameters, especially time-aspects (e.g. periprocedural time loss or duration of mechanical recanalization procedures) will be analyzed with respect to their influence on clinical outcome. The registry is completely independent from industrial sponsoring and is registered at www.clinicaltrials.gov with NCT01399762. The registry is currently recruiting patients. 13 mostly academic centers participate in the registry, 120 patients were entered by now in the database with the intention to include approximately 500 patients. At the International Stroke Conference the structure and goals of ENDOSTROKE will be presented.
- © 2012 by American Heart Association, Inc.