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

• Published in: Neurologia Medico-Chirurgica Vol. 65; no. 5; pp. 247 - 254
• Main Authors: KUWAHARA, Shuntaro, YOSHIMURA, Shinichi, KURAMOTO, Yoji, UCHIDA, Kazutaka, TSUJI, Shoichiro, SHIRAKAWA, Manabu, SHINDO, Koichiro
• Format: Journal Article
• Language: English
• Published: Japan The Japan Neurosurgical Society 15.05.2025; THE JAPAN NEUROSURGICAL SOCIETY; 一般社団法人 日本脳神経外科学会; Japan Science and Technology Agency
• Subjects: acute ischemic stroke; Aged; Aged, 80 and over; Cerebral blood flow; Cerebral infarction; Embolization; Female; Humans; Implants; Ischemia; Ischemic Stroke - surgery; large-vessel occlusion; Male; manually adjustable Tigertriever; Middle Aged; Original; recanalization rate; Retrospective Studies; Statistical analysis; stent-retriever; Stents; Stroke; Subarachnoid hemorrhage; Thrombectomy - instrumentation; Thrombectomy - methods; Thrombolysis; Treatment Outcome; stent-retriever; manually adjustable Tigertriever; large-vessel occlusion; recanalization rate; acute ischemic stroke
• ISSN: 0470-8105; 1349-8029
• DOI: 10.2176/jns-nmc.2024-0297

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.