O-023 Reperfusion with adapt technique using ACE68 and ACE64 is safe and effective in large vessel occlusions of the anterior circulation – the promise study results
Notice bibliographique
Résumé
Purpose PROMISE study aimed to observe the safety and effectiveness of Penumbra System (PS) with ACE68 and ACE64 Reperfusion Catheters in patients with acute ischemic stroke (AIS) from large vessel occlusion (LVO), treated with ADAPT (A Direct Aspiration First Pass Technique) as front-line treatment. Materials and methods This was a prospective, single-arm, multicenter study across 20 European centers. Inclusion criteria were anterior circulation LVO within 6 hours of ictus; NIHSS≥2; CT-ASPECTS ≥6; or MR-ASPECTS ≥5. Primary endpoints included success in angiographic revascularization (mTICI 2b-3), and clinical independence (mRS 0–2) at 90 days. Secondary endpoints included safety events, functional improvement at 7–10 days, procedural metrics and quality of life. mTICI scores and safety endpoints were adjudicated by core laboratory and clinical events committee, respectively. Results A total of 204 patients were enrolled. Median age was 74 [IQR 65–80]. Primary occlusion vessels were 17.2% (35/204) patients with ICA occlusion, 3.9% (8/204) with Carotid T, 60.8% (124/204) with M1% and 18.1% (37/204) with M2. Median baseline CT ASPECT score was 9 [IQR 8–10]. Median baseline and 7–10 day NIHSS scores were 16 [IQR 11–20] and 3 [IQR 1–8], respectively. A reduction of ≤10 points or 7–10 days NIHSS of 0–1 was reported in 67.9% (127/187) patients. Prior to endovascular procedure, IV rtPA was administered in 61.8% (126/204) patients. After PS treatment, 70.3% (142/202) patients achieved mTICI 2b/3. Final revascularization (mTICI 2b/3) was achieved in 93.1% (188/202). Revascularization to mTICI 2 c/3 was achieved 63.9% (129/202). Median time from stroke to revascularization (mTICI 2b/3) was 245.5 min [IQR 192–305]. Median time from puncture to revascularization (mTICI 2b/3) was 31 min [IQR 20–53]. Day-90 mRS of 0–2 was achieved in 61.0% (122/200). In the subgroup analysis by occlusion location, final revascularization (mTICI 2b/3) in the ICA/Carotid T was 95.2% (40/42) and 90 day mRS of 0–2 was achieved in 64.3% (27/42), final revascularization (mTICI 2b/3) in the MCA M1 was 92.7% (114/123) and 90 day mRS of 0–2 was achieved in 57.0% (69/121) and the final revascularization (mTICI 2b/3) in the MCA M2 was 91.9% (34/37) and 90 day mRS of 0–2 was achieved in 70.3% (26/37). There was no significant difference in the safety rates by treatment location. Safety rates were favorable (sICH=2.9%; ENT=1.5%). 90 day morbidity, defined as mRS score (3–5), was observed in 31.5% (63/200). 90 day all cause-mortality was observed in 7.5% (15/200). Device and procedure-related SAEs were reported in 2.0% (4/204) and 4.9% (10/204), respectively. No deaths were device-related. Conclusion PROMISE study demonstrated safety and efficacy with latest generation of PS Reperfusion Catheters (ACE68/64) in patients with acute ischemic stroke from large vessel occlusion, using ADAPT as front-line treatment. Disclosures P. Navia: 2; C; Penumbra Inc. P. Schramm: 2; C; Penumbra Inc. R. Papa: None. J. Parra: None. A. Weitz: None. W. Weber: None. J. Fiehler: None. P. Michel: None. V. Pereira: None. T. Krings: None. L. Pierot: None. J. Gralla: None. P. Santalucia: None. T. Lo: None.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».