EndoVAscular treatment and ThRombolysis for Ischemic Stroke Patients (EVA-TRISP) registry: basis and methodology of a pan-European prospective ischaemic stroke revascularisation treatment registry

Annika Nordanstig; Sami Curtze; Henrik Gensicke; Sanne M Zinkstok; Hebun Erdur; Camilla Karlsson; Jan-Erik Karlsson; Nicolas Martinez-Majander; Gerli Sibolt; Philippe Lyrer; Christopher Traenka; Merih I Baharoglu; Jan F Scheitz; Nicolas Bricout; Hilde Hénon; Didier Leys; Ashraf Eskandari; Patrik Michel; Christian Hametner; Peter Arthur Ringleb; Marcel Arnold; Urs Fischer; Hakan Sarikaya; David J Seiffge; Alessandro Pezzini; Andrea Zini; Visnja Padjen; Dejana R Jovanovic; Andreas Luft; Susanne Wegener; Lars Kellert; Katharina Feil; Georg Kägi; Alexandros Rentzos; Kimmo Lappalainen; Ronen R Leker; Jose E Cohen; John Gomori; Alex Brehm; Jan Liman; Marios Psychogios; Andreas Kastrup; Panagiotis Papanagiotou; Jan Gralla; Mauro Magoni; Charles B L M Majoie; Georg Bohner; Ivan Vukasinovic; Vladimir Cvetic; Johannes Weber; Zsolt Kulcsar; Martin Bendszus; Markus Möhlenbruch; George Ntaios; Eftychia Kapsalaki; Katarina Jood; Christian H Nolte; Paul J J Nederkoorn; Stefan Engelter; Daniel Strbian; Turgut Tatlisumak; EVA-TRISP Investigators

doi:10.1136/bmjopen-2020-042211

EndoVAscular treatment and ThRombolysis for Ischemic Stroke Patients (EVA-TRISP) registry: basis and methodology of a pan-European prospective ischaemic stroke revascularisation treatment registry

BMJ Open. 2021 Aug 9;11(8):e042211. doi: 10.1136/bmjopen-2020-042211.

Authors

Annika Nordanstig^{1

2}, Sami Curtze³, Henrik Gensicke⁴, Sanne M Zinkstok⁵, Hebun Erdur⁶, Camilla Karlsson⁷, Jan-Erik Karlsson^{7

2}, Nicolas Martinez-Majander³, Gerli Sibolt³, Philippe Lyrer⁴, Christopher Traenka⁴, Merih I Baharoglu⁵, Jan F Scheitz⁸, Nicolas Bricout⁹, Hilde Hénon⁹, Didier Leys⁹, Ashraf Eskandari¹⁰, Patrik Michel¹⁰, Christian Hametner¹¹, Peter Arthur Ringleb¹¹, Marcel Arnold¹², Urs Fischer¹², Hakan Sarikaya¹², David J Seiffge¹², Alessandro Pezzini¹³, Andrea Zini¹⁴, Visnja Padjen¹⁵, Dejana R Jovanovic^{15

16}, Andreas Luft¹⁷, Susanne Wegener¹⁷, Lars Kellert¹⁸, Katharina Feil¹⁹, Georg Kägi²⁰, Alexandros Rentzos^{21

22}, Kimmo Lappalainen²³, Ronen R Leker²⁴, Jose E Cohen²⁵, John Gomori²⁶, Alex Brehm²⁷, Jan Liman²⁷, Marios Psychogios^{28

29}, Andreas Kastrup³⁰, Panagiotis Papanagiotou^{31

32}, Jan Gralla³³, Mauro Magoni³⁴, Charles B L M Majoie³⁵, Georg Bohner³⁶, Ivan Vukasinovic³⁷, Vladimir Cvetic^{38

39}, Johannes Weber⁴⁰, Zsolt Kulcsar⁴¹, Martin Bendszus⁴², Markus Möhlenbruch⁴², George Ntaios⁴³, Eftychia Kapsalaki⁴⁴, Katarina Jood^{2

45}, Christian H Nolte⁶, Paul J J Nederkoorn⁵, Stefan Engelter^{46

47}, Daniel Strbian³, Turgut Tatlisumak^{48

49}; EVA-TRISP Investigators

Affiliations

¹ Department of Clinical Neurosciences Sahlgrenska Academy at University of Gothenburg, Sahlgrenska Academy, Goteborg, Sweden [email protected].
² Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden.
³ Department of Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
⁴ Department of Neurology and Stroke Center, University of Basel and University Hospital Basel, Basel, Switzerland.
⁵ Department of Neurology, Amsterdam University Medical Centres, Amsterdam, The Netherlands.
⁶ Department of Neurology and Center for Stroke Research, Charité Universitätsmedizin Berlin, Berlin, Germany.
⁷ Department of Clinical Neurosciences Sahlgrenska Academy at University of Gothenburg, Sahlgrenska Academy, Goteborg, Sweden.
⁸ Department of Neurology and Center for Stroke Research, Charite Universitatsmedizin Berlin Klinik fur Neurologie mit Experimenteller Neurologie, Berlin, Germany.
⁹ Department of Neurology, University of Lille, Lille, France.
¹⁰ Department of Neurology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.
¹¹ Department of Neurology, University Hospital Heidelberg, Heidelberg, Germany.
¹² Department of Neurology, lnselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
¹³ Department of Clinical and Experimental Sciences, Neurology Clinic, University of Brescia, Brescia, Italy.
¹⁴ Department of Neurology and Stroke Center, Maggiore Hospital, IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy.
¹⁵ Neurology Clinic, Clinical Centre of Serbia, Belgrade, Clinical Center of Serbia, Beograd, Serbia.
¹⁶ Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
¹⁷ Department of Neurology, University of Zurich, Zurich, Switzerland.
¹⁸ Department of Neurology, Ludwig-Maximilians-Universitat Munchen, Munchen, Germany.
¹⁹ Neurology and German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-Universitat Munchen, Munchen, Germany.
²⁰ Department of Neurology, Kantonsspital St Gallen, Sankt Gallen, Switzerland.
²¹ Department of Radiology, Institute of clinical sciences, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden.
²² Diagnostic and Interventional Neuroradiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
²³ Department of Radiology, Helsinki University Central Hospital, Helsinki, Finland.
²⁴ Department of Neurology, Hebrew University Hadassah Medical School, Yerushalayim, Israel.
²⁵ Department of Neurosurgery, Hebrew University Hadassah Medical School, Yerushalayim, Israel.
²⁶ Department of Radiology, Hebrew University Hadassah Medical School, Yerushalayim, Israel.
²⁷ Department of Neurology, Georg-August-Universitat Gottingen Universitatsmedizin, Gottingen, Germany.
²⁸ Department of Neuroradiology, Georg-August-Universitat Gottingen Universitatsmedizin, Gottingen, Germany.
²⁹ Neuroradiology and Stroke Center Basel, University of Basel and University Hospital Basel, Basel, Switzerland.
³⁰ Department of Neurology, University Hospitals Bremen-Mitte and Bremen-Ost, Bremen, Germany.
³¹ Clinic for Diagnostic and Interventional Neuroradiology, University Hospitals Bremen-Mitte and Bremen-Ost, University of Bremen, Bremen, Germany.
³² Department of Radiology, Areteion University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
³³ Institute of Diagnostic and Interventional Neuroradiology, lnselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
³⁴ USD Stroke Unit and Vascular Neurology, ASST Spedali Civili di Brescia, Brescia, Italy.
³⁵ Department of Neuroradiology, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
³⁶ Institute of Neuroradiology, Charité-Universitätsmedizin, Berlin, Germany.
³⁷ Clinic of Neurosurgery, Clinical Center of Serbia, Beograd, Serbia.
³⁸ Faculty of Medicine, University of Belgrade, Beograd, Serbia.
³⁹ Clinic for Vascular and Endovascular Surgery, Clinical Centre of Serbia, Belgrade, Serbia.
⁴⁰ Department of Radiology and Nuclear Medicine, Kantonsspital St Gallen, Sankt Gallen, Switzerland.
⁴¹ Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland.
⁴² Department of Neuroradiology, UniversitatsKlinikum Heidelberg, Heidelberg, Germany.
⁴³ Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, Volos, Thessaly, Greece.
⁴⁴ Department of Radiology, University Hospital of Larissa, School of Medicine, University of Thessaly, Volos, Thessaly, Greece.
⁴⁵ Department for Clinical Neuroscience and Rehabilitation, Sahlgrenska Academy, Goteborg, Sweden.
⁴⁶ Department of Neurology and Stroke Center, University of Basel, Basel, Switzerland.
⁴⁷ Deptartment of Radiology, Areteion University Hospital, National and Kapodistrian University of Athens, Athen, Greece.
⁴⁸ Department of Clinical Neurosciences, Sahlgrenska University Hospital, Goteborg, Sweden.
⁴⁹ Department of Neurology, University of Helsinki, Helsinki, Finland.

Abstract

Purpose: The Thrombolysis in Ischemic Stroke Patients (TRISP) collaboration was a concerted effort initiated in 2010 with the purpose to address relevant research questions about the effectiveness and safety of intravenous thrombolysis (IVT). The collaboration also aims to prospectively collect data on patients undergoing endovascular treatment (EVT) and hence the name of the collaboration was changed from TRISP to EVA-TRISP. The methodology of the former TRISP registry for patients treated with IVT has already been published. This paper focuses on describing the EVT part of the registry.

Participants: All centres committed to collecting predefined variables on consecutive patients prospectively. We aim for accuracy and completeness of the data and to adapt local databases to investigate novel research questions. Herein, we introduce the methodology of a recently constructed academic investigator-initiated open collaboration EVT registry built as an extension of an existing IVT registry in patients with acute ischaemic stroke (AIS).

Findings to date: Currently, the EVA-TRISP network includes 20 stroke centres with considerable expertise in EVT and maintenance of high-quality hospital-based registries. Following several successful randomised controlled trials (RCTs), many important clinical questions remain unanswered in the (EVT) field and some of them will unlikely be investigated in future RCTs. Prospective registries with high-quality data on EVT-treated patients may help answering some of these unanswered issues, especially on safety and efficacy of EVT in specific patient subgroups.

Future plans: This collaborative effort aims at addressing clinically important questions on safety and efficacy of EVT in conditions not covered by RCTs. The TRISP registry generated substantial novel data supporting stroke physicians in their daily decision making considering IVT candidate patients. While providing observational data on EVT in daily clinical practice, our future findings may likewise be hypothesis generating for future research as well as for quality improvement (on EVT). The collaboration welcomes participation of further centres willing to fulfill the commitment and the outlined requirements.

Keywords: neurology; stroke; stroke medicine.

MeSH terms

Brain Ischemia* / drug therapy
Endovascular Procedures*
Fibrinolytic Agents / therapeutic use
Humans
Ischemic Stroke*
Registries
Stroke* / drug therapy
Thrombectomy
Thrombolytic Therapy
Treatment Outcome

Substances

Fibrinolytic Agents