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Research ArticleNeurointervention
Open Access

Reduced Mortality and Severe Disability Rates in the SENTIS Trial

P.D. Schellinger, A. Shuaib, M. Köhrmann, D.S. Liebeskind, T. Jovin, M.D. Hammer, S. Sen, D.Y. Huang, S. Solander, R. Gupta, R.R. Leker and J.L. Saver for the SENTIS Trial Investigators
American Journal of Neuroradiology July 2013, DOI: https://doi.org/10.3174/ajnr.A3613
P.D. Schellinger
From JW Klinikum (P.D.S.), Minden, Germany; University of Alberta (A.S.), Edmonton, Alberta, Canada; Universitätsklinikum Erlangen (M.K.), Erlangen, Germany; University of California, Los Angeles (D.S.L., J.L.S.), Los Angeles, California; University of Pittsburgh Medical Center (T.J., M.D.H.), Pittsburgh, Pennsylvania; St Thomas Hospital (S.Sen), Nashville, Tennessee; University of South Carolina (D.Y.H.), Columbia, South Carolina; University of North Carolina (S.Solander), Chapel Hill, North Carolina; Emory University (R.G.), Atlanta, Georgia; and Hadassah Hebrew University Medical Center (R.R.L.), Jerusalem, Israel.
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A. Shuaib
From JW Klinikum (P.D.S.), Minden, Germany; University of Alberta (A.S.), Edmonton, Alberta, Canada; Universitätsklinikum Erlangen (M.K.), Erlangen, Germany; University of California, Los Angeles (D.S.L., J.L.S.), Los Angeles, California; University of Pittsburgh Medical Center (T.J., M.D.H.), Pittsburgh, Pennsylvania; St Thomas Hospital (S.Sen), Nashville, Tennessee; University of South Carolina (D.Y.H.), Columbia, South Carolina; University of North Carolina (S.Solander), Chapel Hill, North Carolina; Emory University (R.G.), Atlanta, Georgia; and Hadassah Hebrew University Medical Center (R.R.L.), Jerusalem, Israel.
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M. Köhrmann
From JW Klinikum (P.D.S.), Minden, Germany; University of Alberta (A.S.), Edmonton, Alberta, Canada; Universitätsklinikum Erlangen (M.K.), Erlangen, Germany; University of California, Los Angeles (D.S.L., J.L.S.), Los Angeles, California; University of Pittsburgh Medical Center (T.J., M.D.H.), Pittsburgh, Pennsylvania; St Thomas Hospital (S.Sen), Nashville, Tennessee; University of South Carolina (D.Y.H.), Columbia, South Carolina; University of North Carolina (S.Solander), Chapel Hill, North Carolina; Emory University (R.G.), Atlanta, Georgia; and Hadassah Hebrew University Medical Center (R.R.L.), Jerusalem, Israel.
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D.S. Liebeskind
From JW Klinikum (P.D.S.), Minden, Germany; University of Alberta (A.S.), Edmonton, Alberta, Canada; Universitätsklinikum Erlangen (M.K.), Erlangen, Germany; University of California, Los Angeles (D.S.L., J.L.S.), Los Angeles, California; University of Pittsburgh Medical Center (T.J., M.D.H.), Pittsburgh, Pennsylvania; St Thomas Hospital (S.Sen), Nashville, Tennessee; University of South Carolina (D.Y.H.), Columbia, South Carolina; University of North Carolina (S.Solander), Chapel Hill, North Carolina; Emory University (R.G.), Atlanta, Georgia; and Hadassah Hebrew University Medical Center (R.R.L.), Jerusalem, Israel.
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T. Jovin
From JW Klinikum (P.D.S.), Minden, Germany; University of Alberta (A.S.), Edmonton, Alberta, Canada; Universitätsklinikum Erlangen (M.K.), Erlangen, Germany; University of California, Los Angeles (D.S.L., J.L.S.), Los Angeles, California; University of Pittsburgh Medical Center (T.J., M.D.H.), Pittsburgh, Pennsylvania; St Thomas Hospital (S.Sen), Nashville, Tennessee; University of South Carolina (D.Y.H.), Columbia, South Carolina; University of North Carolina (S.Solander), Chapel Hill, North Carolina; Emory University (R.G.), Atlanta, Georgia; and Hadassah Hebrew University Medical Center (R.R.L.), Jerusalem, Israel.
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M.D. Hammer
From JW Klinikum (P.D.S.), Minden, Germany; University of Alberta (A.S.), Edmonton, Alberta, Canada; Universitätsklinikum Erlangen (M.K.), Erlangen, Germany; University of California, Los Angeles (D.S.L., J.L.S.), Los Angeles, California; University of Pittsburgh Medical Center (T.J., M.D.H.), Pittsburgh, Pennsylvania; St Thomas Hospital (S.Sen), Nashville, Tennessee; University of South Carolina (D.Y.H.), Columbia, South Carolina; University of North Carolina (S.Solander), Chapel Hill, North Carolina; Emory University (R.G.), Atlanta, Georgia; and Hadassah Hebrew University Medical Center (R.R.L.), Jerusalem, Israel.
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S. Sen
From JW Klinikum (P.D.S.), Minden, Germany; University of Alberta (A.S.), Edmonton, Alberta, Canada; Universitätsklinikum Erlangen (M.K.), Erlangen, Germany; University of California, Los Angeles (D.S.L., J.L.S.), Los Angeles, California; University of Pittsburgh Medical Center (T.J., M.D.H.), Pittsburgh, Pennsylvania; St Thomas Hospital (S.Sen), Nashville, Tennessee; University of South Carolina (D.Y.H.), Columbia, South Carolina; University of North Carolina (S.Solander), Chapel Hill, North Carolina; Emory University (R.G.), Atlanta, Georgia; and Hadassah Hebrew University Medical Center (R.R.L.), Jerusalem, Israel.
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D.Y. Huang
From JW Klinikum (P.D.S.), Minden, Germany; University of Alberta (A.S.), Edmonton, Alberta, Canada; Universitätsklinikum Erlangen (M.K.), Erlangen, Germany; University of California, Los Angeles (D.S.L., J.L.S.), Los Angeles, California; University of Pittsburgh Medical Center (T.J., M.D.H.), Pittsburgh, Pennsylvania; St Thomas Hospital (S.Sen), Nashville, Tennessee; University of South Carolina (D.Y.H.), Columbia, South Carolina; University of North Carolina (S.Solander), Chapel Hill, North Carolina; Emory University (R.G.), Atlanta, Georgia; and Hadassah Hebrew University Medical Center (R.R.L.), Jerusalem, Israel.
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S. Solander
From JW Klinikum (P.D.S.), Minden, Germany; University of Alberta (A.S.), Edmonton, Alberta, Canada; Universitätsklinikum Erlangen (M.K.), Erlangen, Germany; University of California, Los Angeles (D.S.L., J.L.S.), Los Angeles, California; University of Pittsburgh Medical Center (T.J., M.D.H.), Pittsburgh, Pennsylvania; St Thomas Hospital (S.Sen), Nashville, Tennessee; University of South Carolina (D.Y.H.), Columbia, South Carolina; University of North Carolina (S.Solander), Chapel Hill, North Carolina; Emory University (R.G.), Atlanta, Georgia; and Hadassah Hebrew University Medical Center (R.R.L.), Jerusalem, Israel.
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R. Gupta
From JW Klinikum (P.D.S.), Minden, Germany; University of Alberta (A.S.), Edmonton, Alberta, Canada; Universitätsklinikum Erlangen (M.K.), Erlangen, Germany; University of California, Los Angeles (D.S.L., J.L.S.), Los Angeles, California; University of Pittsburgh Medical Center (T.J., M.D.H.), Pittsburgh, Pennsylvania; St Thomas Hospital (S.Sen), Nashville, Tennessee; University of South Carolina (D.Y.H.), Columbia, South Carolina; University of North Carolina (S.Solander), Chapel Hill, North Carolina; Emory University (R.G.), Atlanta, Georgia; and Hadassah Hebrew University Medical Center (R.R.L.), Jerusalem, Israel.
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R.R. Leker
From JW Klinikum (P.D.S.), Minden, Germany; University of Alberta (A.S.), Edmonton, Alberta, Canada; Universitätsklinikum Erlangen (M.K.), Erlangen, Germany; University of California, Los Angeles (D.S.L., J.L.S.), Los Angeles, California; University of Pittsburgh Medical Center (T.J., M.D.H.), Pittsburgh, Pennsylvania; St Thomas Hospital (S.Sen), Nashville, Tennessee; University of South Carolina (D.Y.H.), Columbia, South Carolina; University of North Carolina (S.Solander), Chapel Hill, North Carolina; Emory University (R.G.), Atlanta, Georgia; and Hadassah Hebrew University Medical Center (R.R.L.), Jerusalem, Israel.
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J.L. Saver
From JW Klinikum (P.D.S.), Minden, Germany; University of Alberta (A.S.), Edmonton, Alberta, Canada; Universitätsklinikum Erlangen (M.K.), Erlangen, Germany; University of California, Los Angeles (D.S.L., J.L.S.), Los Angeles, California; University of Pittsburgh Medical Center (T.J., M.D.H.), Pittsburgh, Pennsylvania; St Thomas Hospital (S.Sen), Nashville, Tennessee; University of South Carolina (D.Y.H.), Columbia, South Carolina; University of North Carolina (S.Solander), Chapel Hill, North Carolina; Emory University (R.G.), Atlanta, Georgia; and Hadassah Hebrew University Medical Center (R.R.L.), Jerusalem, Israel.
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Abstract

BACKGROUND AND PURPOSE: The Safety and Efficacy of NeuroFlo Technology in Ischemic Stroke trial showed a trend for reduced all-cause mortality and positive secondary safety end point outcomes. We present further analyses of the mortality and severe disability data from the Safety and Efficacy of NeuroFlo Technology in Ischemic Stroke trial.

MATERIALS AND METHODS: The Safety and Efficacy of NeuroFlo Technology in Ischemic Stroke trial was a multicenter, randomized, controlled trial that evaluated the safety and effectiveness of the NeuroFlo catheter in patients with stroke. The current analysis was performed on the as-treated population. All-cause and stroke-related mortality rates at 90 days were compared between groups, and logistic regression models were fit to obtain ORs and 95% CIs for the treated versus not-treated groups. We categorized death-associated serious adverse events as neurologic versus non-neurologic events and performed multiple logistic regression analyses. We analyzed severe disability and mortality by outcomes of the mRS. Patient allocation was gathered by use of a poststudy survey.

RESULTS: All-cause mortality trended in favor of treated patients (11.5% versus 16.1%; P = .079) and stroke-related mortality was significantly reduced in treated patients (7.5% versus 14.2%; P = .009). Logistic regression analysis for freedom from stroke-related mortality favored treatment (OR, 2.41; 95% CI, 1.22, 4.77; P = .012). Treated patients had numerically fewer neurologic causes of stroke-related deaths (52.9% versus 73.0%; P = .214). Among the 90-day survivors, nominally fewer treated patients were severely disabled (mRS 5) (5.6% versus 7.5%; OR, 1.72; 95% CI, 0.72, 4.14; P = .223). Differences in allocation of care did not account for the reduced mortality rates.

CONCLUSIONS: There were consistent reductions in all-cause and stroke-related mortality in the NeuroFlo-treated patients. This reduction in mortality did not result in an increase in severe disability.

Abbreviations

SENTIS
Safety and Efficacy of NeuroFlo Technology in Ischemic Stroke
NIHSSS
National Institutes of Health Stroke Scale Score
  • © 2013 American Society of Neuroradiology

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P.D. Schellinger, A. Shuaib, M. Köhrmann, D.S. Liebeskind, T. Jovin, M.D. Hammer, S. Sen, D.Y. Huang, S. Solander, R. Gupta, R.R. Leker, J.L. Saver
Reduced Mortality and Severe Disability Rates in the SENTIS Trial
American Journal of Neuroradiology Jul 2013, DOI: 10.3174/ajnr.A3613

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Reduced Mortality and Severe Disability Rates in the SENTIS Trial
P.D. Schellinger, A. Shuaib, M. Köhrmann, D.S. Liebeskind, T. Jovin, M.D. Hammer, S. Sen, D.Y. Huang, S. Solander, R. Gupta, R.R. Leker, J.L. Saver
American Journal of Neuroradiology Jul 2013, DOI: 10.3174/ajnr.A3613
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