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Author Notes:

Correspondence to: Dr Reza Jahan, Division of Interventional Neuroradiology, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Suite 2129, Los Angeles, CA 90095-7430, USA; rjahan@mednet.ucla.edu.

See publication for full list of author contributions.

All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

The authors thank Jill Schafer for assistance with performing and independently verifying the statistical analysis in this manuscript.

See publication for full list of disclosures.

Subjects:

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Neuroimaging
  • Surgery
  • Neurosciences & Neurology
  • ACUTE ISCHEMIC-STROKE
  • FLOW-RESTORATION DEVICE
  • LARGE VESSEL OCCLUSIONS
  • ENDOVASCULAR TREATMENT
  • MERCI TRIAL
  • THROMBECTOMY
  • EFFICACY
  • SAFETY
  • RECANALIZATION

Rapid learning curve for Solitaire FR stent retriever therapy: evidence from roll-in and randomised patients in the SWIFT trial

Tools:

Journal Title:

Journal of NeuroInterventional Surgery

Volume:

Volume 8, Number 4

Publisher:

, Pages 347-352

Type of Work:

Article | Post-print: After Peer Review

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.

Copyright information:

© 2017 by the Society of NeuroInterventional Surgery. All rights reserved.

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