E-142 Looking back to move forward: a decade of evidence for embotrap

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Introduction Mechanical thrombectomy with stent-retrievers is a well-established treatment approach for acute ischemic stroke (AIS), providing safe and effective outcomes for patients with large vessel occlusions. The breadth of evidence over the past decade for EmboTrap, a commonly used SR in mechanical thrombectomy, has been examined. Methods A systematic review of the literature was conducted by searching PubMed, MEDLINE, Cochrane, and Springer databases from inception until December 2025 on the Nested Knowledge platform for studies (RCTs, prospective, retrospective, case series) that included EmboTrap. We excluded studies that were non-original, <5 patients, health-economic, meta-analysis/systematic reviews, in vitro, or where Embotrap was not used in AIS. Main outcomes of interest were the safety and efficacy of EmboTrap. Data was extracted for first pass recanalization rate (mFPR, FPR), final TICI (or mTICI/eTICI, as reported), rescue stenting, embolization to new territory (ENT), vessel dissection/perforation, symptomatic intracranial hemorrhage (sICH), mortality and 90-day modified Rankin Scale (mRS). The random effects model was used. All outcomes were statistically analyzed with a 95% confidence interval. Results A total of 432 articles were screened, of which 23 were included for analysis, published between 2015-2025. EmboTrap was used as a first-line stent retriever (±aspiration) in 3451 patients. The mean age was 71.1 years [95% CI: 69.7, 72.6], and baseline NIHSS was 16.1 [15.5, 16.6]. M1 occlusion was the most common location at 61.9%, M2 in 15.3% and Basilar in 4.2%. IV-Lysis was used in 33.7% [17.7%, 54.7%], and balloon guide catheter in 57.3% ([45.1%, 68.6%], n=1477/2506) of patients. FPR 2c-3 was documented in 40.8% of patients ([36.7%, 45.1%], n=860/2167), and mFPR 2b-3 in 52.7% ([42.9%, 62.3%], n=1270/2279). Final mTICI 2b-3 was 90.2% (95% CI [85.8%, 93.3%], n=1813/2007),and final mTICI 2c-3 at 61.7% ([52.9%, 69.9%], n=782/1252). Rescue stenting in 3.44% ([2.51%, 4.69%], n=38/1107), ENT was reported in 3.86% of patients ([2.13%, 6.91%], n=61/2182), and vessel dissection/perforation in 1.22% ([0.410%, 3.56%], n=5/553). 90-day mRS 0-2 was documented in 44.2% of patients ([37.2%, 51.5%], n=1226/2880) and sICH in 5.21% ([3.05%, 8.76%], n=125/2473). All-cause mortality was 14.3% ([9.91%, 20.1%], n= 418/2422). Conclusions This analysis reports a decade of data demonstrating the safety and effectiveness of EmboTrap. Finding high first pass and final recanalization rates, with favorable functional outcomes and low number of safety events. Disclosures R. Laverick: 5; C; Johnson and Johnson. P. Brouwer: 5; C; Johnson and Johnson. M. Mirza: 5; C; Johnson and Johnson.

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