Comparison of non-stent retriever and stent retriever mechanical thrombectomy devices for the endovascular treatment of acute ischemic stroke

Kate A. Hentschel, Badih Daou, Nohra Chalouhi, Robert M. Starke, Shannon Clark, Ashish Gandhe, Pascal Jabbour, Robert Rosenwasser, Stavropoula Tjoumakaris

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


OBJECTIVE: Mechanical thrombectomy is standard of care for the treatment of acute ischemic stroke. However, limited data are available from assessment of outcomes of FDA-approved devices. The objective of this study is to compare clinical outcomes, efficacy, and safety of non-stent retriever and stent retriever thrombectomy devices. METHODS: Between January 2008 and June 2014, 166 patients treated at Jefferson Hospital for Neuroscience for acute ischemic stroke with mechanical thrombectomy using Merci, Penumbra, Solitaire, or Trevo devices were retrospectively reviewed. Primary outcomes included 90-day modified Rankin Scale (mRS) score, recanalization rate (thrombolysis in cerebral infarction [TICI score]), and incidence of symptomatic intracranial hemorrhages (ICHs). Univariate analysis and multivariate logistic regression determined predictors of mRS Score 3-6, mortality, and TICI Score 3. RESULTS: A total of 99 patients were treated with non-stent retriever devices (Merci and Penumbra) and 67 with stent retrievers (Solitaire and Trevo). Stent retrievers yielded lower 90-day NIH Stroke Scale scores and higher rates of 90-day mRS scores ≤ 2 (22.54% [non-stent retriever] vs 61.67% [stent retriever]; p < 0.001), TICI Score 2b-3 recanalization rates (79.80% [non-stent retriever] vs 97.01% [stent retriever]; p < 0.001), percentage of parenchyma salvaged, and discharge rates to home/rehabilitation. The overall incidence of ICH was also significantly lower (40.40% [non-stent retriever] vs 13.43% [stent retriever]; p = 0.002), with a trend toward lower 90-day mortality. Use of non-stent retriever devices was an independent predictor of mRS Scores 3-6 (p = 0.002), while use of stent retrievers was an independent predictor of TICI Score 3 (p < 0.001). CONCLUSIONS: Stent retriever mechanical thrombectomy devices achieve higher recanalization rates than non-stent retriever devices in acute ischemic stroke with improved clinical and radiographic outcomes and safety.

Original languageEnglish (US)
Pages (from-to)1123-1130
Number of pages8
JournalJournal of neurosurgery
Issue number4
StatePublished - Apr 2017
Externally publishedYes


  • Endovascular procedures
  • Interventional neurosurgery
  • Stroke
  • Thrombectomy
  • Vascular disorders

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


Dive into the research topics of 'Comparison of non-stent retriever and stent retriever mechanical thrombectomy devices for the endovascular treatment of acute ischemic stroke'. Together they form a unique fingerprint.

Cite this