Abstract Details

Title IMS-III Like Subgroup Analysis in the North American SOLITAIRE Stent-Retriever Acute Stroke Registry

Topic Interventional Neurology

Presentation(s) (-)

Poster/Presentation
Number 011

Objective

Background IMS-III demonstrated no significant difference between treatment with IV-rtPA alone or IV-rtPA plus IA therapy. However, the trial included only earlier generations of thrombectomy devices and did not evaluate the efficacy of newer devices.

Design/Methods The investigator-initiated NASA Registry recruited sites within North America to submit data on consecutive patients treated with Solitaire-FR. A cohort similar to the IMS-III IV-rtPA+Solitaire-FR population was identified and compared to those receiving Solitaire-FR alone. SICH was defined as any parenchymal hematoma, SAH, or IVH associated with a worsening of the NIHSS score by 4 or more within 24 hours. Successful recanalization was defined as TIMI ≥2. Good clinical outcome was defined as a 90-day mRS ≤2.

Results 334 patients underwent treatment using the SOLITAIRE-FR device in 23 centers. Mean age was 67.3±15.1 years; mean NIHSS was 18 (IQR 14-23). Of those, 44% (147/333) were treated with IV-rtPA+Solitaire-FR versus 56% (186/333) with Solitaire-FR alone. Recanalization rate was 86.4% (127/147) in the IV-rtPA+Solitaire-FR versus 82.3% (153/186) in the SOLITAIRE-FR only group (p=0.4). sICH was noted in 11% (16/146) of IV-rtPA+Solitaire-FR patients compared to 9.2% (17/185) in the Solitaire-FR group (p=0.7). In IV-rtPA+Solitaire-FR patients with available outcomes, 52% (66/127) had achieved a 90-day good clinical outcome versus 35.6% (57/160) of patients treated with Solitaire-FR alone (p=0.006). Mortality was 25% (33/132) in the IV-rtPA+Solitaire-FR versus 35.4% (58/164) in Solitaire-FR alone groups (p=0.06).

Conclusions In the NASA registry, the IMS-III like group (IV-rtPA+Solitaire-FR) demonstrated a higher rate of good clinical outcome versus treatment with Solitaire alone and a trend towards reduced mortality.

Authors/Disclosures
Osama O. Zaidat, MD, FAAN (Neuroscience and Stroke Medical Director St Vincent Mercy Hospital)	Dr. Zaidat has nothing to disclose.
	No disclosure on file
Rishi Gupta, MD	No disclosure on file
	No disclosure on file
Coleman Martin, MD	No disclosure on file
	No disclosure on file
Michael S. Okun, MD, FAAN (University of Florida)	Dr. Okun has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NIH. Dr. Okun has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Parkinson's Foundation. Dr. Okun has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA Neurology. Dr. Okun has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for NEJM Journal Watch. The institution of Dr. Okun has received research support from NIH. The institution of Dr. Okun has received research support from Parkinson's Foundation. The institution of Dr. Okun has received research support from Tourette Association of America. The institution of Dr. Okun has received research support from Michael J Fox. Dr. Okun has received publishing royalties from a publication relating to health care.
	No disclosure on file
Joey English, MD, PhD	No disclosure on file
Italo Linfante, MD (Miami Cardiac And Vascular Institute, Baptist Hospital and Neuroscience Center)	Dr. Linfante has received personal compensation for serving as an employee of medtronic. Dr. Linfante has received personal compensation for serving as an employee of stryker. Dr. Linfante has received personal compensation for serving as an employee of cerenovus. Dr. Linfante has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for medtronic. Dr. Linfante has received stock or an ownership interest from InNeuroCO. Dr. Linfante has received stock or an ownership interest from Stryker/Surpass.
	No disclosure on file
	No disclosure on file
Franklin Marden, MD, FAAN	No disclosure on file
Hormozd Bozorgchami, MD (Oregon Health & Science University)	No disclosure on file
Andrew Xavier, MD (Neuro Team One)	No disclosure on file
	No disclosure on file
Michael T. Froehler, MD, PhD	No disclosure on file
Aamir Badruddin, MD (Taj Enterprise)	Dr. Badruddin has received intellectual property interests from a discovery or technology relating to health care.
Thanh Nguyen, MD	Dr. Nguyen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Vesalio. Dr. Nguyen has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NIH. Dr. Nguyen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Avania. Dr. Nguyen has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for AHA. The institution of Dr. Nguyen has received research support from Boston Medical Center. The institution of Dr. Nguyen has received research support from Society of Vascular and Interventional Neurology.
	No disclosure on file
Michael G. Abraham, MD (The University of Kansas Health System)	Dr. Abraham has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Stryker Neurovascular.
Vallabh Janardhan, MD, FAAN	No disclosure on file
Hashem Shaltoni, MD	Dr. Shaltoni has nothing to disclose.
	No disclosure on file
	No disclosure on file
Peng R. Chen (University of Texas McGovern Medical School)	Peng R. Chen has nothing to disclose.
Alex B. Chebl, MD (Henry Ford Health System)	No disclosure on file
Ashish Nanda, MD (SSM health Neurosciences)	No disclosure on file
Ritesh Kaushal, MD, PhD (University of Chicago)	Dr. Kaushal has nothing to disclose.
	No disclosure on file
Raul G. Nogueira, MD (UPMC Stroke Institute)	Dr. Nogueira has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for for advisory roles with Anaconda, Biogen, Cerenovus, Genentech, Hybernia, Imperative Care, Medtronic, Phenox, Philips, Prolong Pharmaceuticals, Stryker Neurovascular, Shanghai Wallaby, and Synchron (consulting fees) as well as for advisory roles with Astrocyte, Brainomix, Cerebrotech, Ceretrieve, Corindus Vascular Robotics, Vesalio, Viz-AI, RapidPulse and Perfuze ( stock options). Dr. Nogueira has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Law Firms. Dr. Nogueira has received stock or an ownership interest from Viz-AI, Perfuze, Cerebrotech, Reist/Q'Apel Medical, Truvic, and Viseon. The institution of Dr. Nogueira has received research support from Cerenovus.

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