title: Comparison of clinical outcomes in patients with acute ischemic strokes treated with mechanical thrombectomy using either Solumbra or ADAPT techniques.
abstract: OBJECTIVE
  To compare rates of symptomatic intracranial hemorrhage (SICH) and good clinical outcome at 90 days in patients with ischemic strokes from anterior circulation emergent large vessel occlusions (ELVO) treated with mechanical thrombectomy using either Solumbra or A Direct Aspiration first-Pass Thrombectomy (ADAPT) techniques.
  
  
  METHODS
  We compared clinical characteristics, procedural variables, and clinical outcomes in patients with anterior circulation ELVOs treated with mechanical thrombectomy using either a Solumbra or ADAPT technique at our institution over a 38-month period. SICH was defined using the SITS-MOST criteria. A good clinical outcome was defined as a modified Rankin Scale score of 0-2 at 90 days.
  
  
  RESULTS
  One hundred patients were included, 55 in the Solumbra group and 45 in the ADAPT group. Patients in the ADAPT group had higher National Institutes of Health Stroke Scale (NIHSS) (19.2 vs 16.8, p=0.02) and a higher proportion of internal carotid artery terminus thrombi (42.2% vs 20%, p=0.03) than patients in the Solumbra group. Patients in the ADAPT group had a trend toward a lower rate of SICH than patients in the Solumbra group (2.2% vs 12.7%, p=0.07). Patients in the ADAPT group had a significantly higher rate of good clinical outcome at 90 days than patients in the Solumbra group (55.6% vs 30.9%, p=0.015). Use of the ADAPT technique (OR 6 (95% CI 1.0 to 31.2), p=0.049) was an independent predictor of a good clinical outcome at 90 days in our cohort.
  
  
  CONCLUSIONS
  In our cohort, the ADAPT technique was associated with significantly higher good clinical outcomes at 90 days in patients with acute ischemic stroke due to anterior circulation ELVOs treated with mechanical thrombectomy.
authors.affiliation: Division of Neurointerventional Radiology, Neuroscience Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA.
authors.forename: Josser E
authors.initials: JE
authors.lastname: Delgado Almandoz
authors.affiliation: Division of Neurointerventional Radiology, Neuroscience Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA.
authors.forename: Yasha
authors.identifier: http://orcid.org/0000-0002-7747-0188
authors.initials: Y
authors.lastname: Kayan
authors.affiliation: Division of Vascular Neurology, Neuroscience Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA.
authors.forename: Mark L
authors.initials: ML
authors.lastname: Young
authors.affiliation: Division of Neurointerventional Radiology, Neuroscience Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Fease
authors.affiliation: Division of Neurointerventional Radiology, Neuroscience Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA.
authors.forename: Jill M
authors.initials: JM
authors.lastname: Scholz
authors.affiliation: Division of Neurointerventional Radiology, Neuroscience Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Milner
authors.affiliation: Division of Vascular Neurology, Neuroscience Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA.
authors.forename: Timothy H
authors.initials: TH
authors.lastname: Hehr
authors.affiliation: Division of Vascular Neurology, Neuroscience Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA.
authors.forename: Pezhman
authors.initials: P
authors.lastname: Roohani
authors.affiliation: Division of Critical Care Medicine, Neuroscience Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Mulder
authors.affiliation: Division of Vascular Neurology, Neuroscience Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA.
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Tarrel
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000175:diagnosis / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020521:Stroke / Q000175:diagnosis / Q000601:surgery*; D017131:Thrombectomy / Q000379:methods* / Q000639:trends; D016896:Treatment Outcome
keywords: Catheter; Intervention; Stent; Stroke; Thrombectomy