Single-Center Experience of Mechanical Thrombectomy with the Trevo XP ProVue 6 × 25 mm Stent Retriever in Middle Cerebral Artery Occlusion: Comparison with Trevo XP ProVue 4 × 20 mm

Background There are few studies assessing the suitable stent size for mechanical thrombectomy in middle cerebral artery (MCA) occlusion. We attempted to determine what size of stent is suitable for thrombectomy in MCA occlusion through a comparison of Trevo XP 6 × 25 mm and 4 × 20 mm stents. Methods We changed Trevo XP 4 × 20 mm stents to Trevo XP 6 × 25 mm stents for thrombectomy in MCA occlusion with the hypothesis that a larger stent would have better outcomes. Retrospectively, 87 patients were divided into 2 groups: the Trevo XP 6 × 25 mm stent group and Trevo XP 4 × 20 mm stent group, and a comparative study was performed in terms of clinical and radiologic outcomes and complications. Results The proportion of patients with a good clinical outcome and successful recanalization was higher in the Trevo XP 6 × 25 mm stent group than in the Trevo XP 4 × 20 mm stent group, with statistical significance (P = 0.041, P = 0.036). In multivariate analysis, the use of the Trevo 6 × 25 mm stent was a predictive factor for a good clinical outcome (odds ratio, 1.22; 95% confidence interval, 1.06–1.38; P = 0.03) and successful recanalization (odds ratio, 1.89; 95% confidence interval, 1.25–2.87; P = 0.018). However, there was no statistically significant difference in complications between the 2 groups. Conclusions Our study showed that the Trevo XP 6 × 25 mm stent provides better clinical and radiologic outcomes than the Trevo XP 4 × 20 mm stent for MCA occlusion without an increase in the rate of complications.