title: Rapid learning curve for Solitaire FR stent retriever therapy: evidence from roll-in and randomised patients in the SWIFT trial.
abstract: BACKGROUND
  In light of recent positive trial data for endovascular therapy in acute ischemic stroke (AIS), stent retriever use by practitioners without prior experience with these devices may become more common.
  
  
  OBJECTIVE
  To assess the safety and efficacy of thrombectomy for AIS using Solitaire for patients treated in the roll-in period of the Solitaire With the Intention For Thrombectomy (SWIFT) trial, which represented the first clinical use of the device for these interventionalists.
  
  
  METHODS
  Prospectively collected demographic, clinical, and angiographic data on patients treated in the initial roll-in and subsequent randomized phases of the SWIFT study were collected and analyzed. Key statistical analyses were validated by an independent external statistician.
  
  
  RESULTS
  Patients in the roll-in period achieved equivalently high rates of reperfusion (55%) compared with those treated with the device in the randomized phase (61%). Rates of adverse events were comparable (13% vs. 9%). Rates of good neurological outcome were equivalent between the roll-in and randomized patients treated with Solitaire (63% vs. 58%). Including the roll-in patients strengthened the conclusions of the study, that reperfusion rates without symptomatic hemorrhage with Solitaire were greater than with Merci (59% vs. 24%, p<0.001).
  
  
  CONCLUSIONS
  Thrombectomy in AIS using the Solitaire stent retriever device can be performed safely and effectively when used by experienced neurointerventionalists without previous experience with the device.
  
  
  BACKGROUND
  The SWIFT study is registered with ClinicalTrials.gov, number NCT 01054560.
authors: Department of Radiology and Stroke Center, University of California, Los Angeles, Los Angeles, California, USA.
authors: Sunil A
authors: SA
authors: Sheth
authors: Department of Radiology and Stroke Center, University of California, Los Angeles, Los Angeles, California, USA.
authors: Reza
authors: R
authors: Jahan
authors: Department of Neurosurgery, Millard Fillmore Hospital, Buffalo, New York, USA.
authors: Elad I
authors: EI
authors: Levy
authors: Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors: Tudor G
authors: TG
authors: Jovin
authors: Department of Radiology, Erlanger Hospital, Chattanooga, Tennessee, USA.
authors: Blaise
authors: B
authors: Baxter
authors: Department of Neurology, Emory University, Atlanta, Georgia, USA.
authors: Raul G
authors: RG
authors: Nogueira
authors: Department of Neurology, Oregon Health Science University, Portland, Oregon, USA.
authors: Wayne
authors: W
authors: Clark
authors: Department of Radiology, Riverside Methodist Hospital, Columbus, Ohio, USA.
authors: Ronald
authors: R
authors: Budzik
authors: Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
authors: Osama O
authors: OO
authors: Zaidat
authors: Department of Neurology and Stroke Center, University of California, Los Angeles, Los Angeles, California, USA.
authors: Jeffrey L
authors: JL
authors: Saver
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015607:Stents; D020521:Stroke / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate / Q000639:trends; D017131:Thrombectomy / Q000379:methods* / Q000401:mortality / Q000639:trends
keywords: Angiography; Intervention; Stroke; Technique; Thrombectomy