scholarly journals Letter by Simonsen et al Regarding Article, “Balloon Guide Catheter Improves Revascularization and Clinical Outcomes With the Solitaire Device: Analysis of the North American Solitaire Acute Stroke Registry”

Stroke ◽  
2014 ◽  
Vol 45 (5) ◽  
Author(s):  
Claus Z. Simonsen ◽  
Leif H. Sørensen ◽  
Grethe Andersen
Keyword(s):  
Acute Stroke ◽  
Clinical Outcomes ◽  
North American ◽  
Stroke Registry ◽  
The North ◽  
Guide Catheter

scholarly journals Influence of Age on Clinical and Revascularization Outcomes in the North American Solitaire Stent-Retriever Acute Stroke Registry

Stroke ◽  
2014 ◽  
Vol 45 (12) ◽  
pp. 3631-3636 ◽  
Author(s):  
Alicia C. Castonguay ◽  
Osama O. Zaidat ◽  
Roberta Novakovic ◽  
Thanh N. Nguyen ◽  
M. Asif Taqi ◽  
...  
Keyword(s):  
Acute Stroke ◽  
North American ◽  
Stent Retriever ◽  
Stroke Registry ◽  
The North

scholarly journals Clinical and Angiographic Outcomes with the Combined Local Aspiration and Retriever in the North American Solitaire Stent-Retriever Acute Stroke (NASA) Registry

2017 ◽  
Vol 7 (1-2) ◽  
pp. 26-35 ◽  
Author(s):  
Tim W. Malisch ◽  
Osama O. Zaidat ◽  
Alicia C. Castonguay ◽  
Franklin A. Marden ◽  
Rishi Gupta ◽  
...  
Keyword(s):  
Acute Stroke ◽  
North American ◽  
Mechanical Thrombectomy ◽  
Small Sample Size ◽  
Small Sample ◽  
The North ◽  
The Arts ◽  
Guide Catheter ◽  
Significant Difference ◽  
The Impact

Background: Various techniques are used to enhance the results of mechanical thrombectomy with stent-retrievers, including proximal arrest with balloon guide catheter (BGC), conventional large bore proximal catheter (CGC), or in combination with local aspiration through a large-bore catheter positioned at the clot interface (Aspiration-Retriever Technique for Stroke [ARTS]). We evaluated the impact of ARTS in the North American Solitaire Acute Stroke (NASA) registry. Summary: Data on the use of the aspiration technique were available for 285 anterior circulation patients, of which 29 underwent ARTS technique, 131 CGC, and 125 BGC. Baseline demographics were comparable, except that ARTS patients are less likely to have hypertension or atrial fibrillation. The ARTS group had more ICA occlusions (41.4 vs. 22% in the BGC, p = 0.04 and 26% in CGC, p = 0.1) and less MCA/M1 occlusions (44.8 vs. 68% in BGC and 62% in CGC). Time from arterial puncture to reperfusion or end of procedure with ARTS was shorter than with CGC (54 vs. 91 min, p = 0.001) and was comparable to the BGC time (54 vs. 67, p = 0.11). Final degree of reperfusion was comparable among the groups (TICI [modified Thrombolysis in Cerebral Infarction] score 2b or higher was 72 vs. 70% for CGC vs. 78% for BGC). Procedural complications, mortality, and good clinical outcome at 90 days were similar between the groups. Key Messages: The ARTS mechanical thrombectomy in acute ischemic stroke patients appears to yield better results as compared to the use of CGCs with no significant difference when compared to BGC. This early ARTS technique NASA registry data are limited by the earlier generation distal large bore catheters and small sample size. Future studies should focus on the comparison of ARTS and BGC techniques.

scholarly journals North American SOLITAIRE Stent-Retriever Acute Stroke Registry

Stroke ◽  
2014 ◽  
Vol 45 (5) ◽  
pp. 1396-1401 ◽  
Author(s):  
Alex Abou-Chebl ◽  
Ossama O. Zaidat ◽  
Alicia C. Castonguay ◽  
Rishi Gupta ◽  
Chung-Huan J. Sun ◽  
...  
Keyword(s):  
Acute Stroke ◽  
North American ◽  
Stent Retriever ◽  
Stroke Registry

North American Solitaire Stent Retriever Acute Stroke registry: post-marketing revascularization and clinical outcome results

2013 ◽  
Vol 6 (8) ◽  
pp. 584-588 ◽  
Author(s):  
Osama O Zaidat ◽  
Alicia C Castonguay ◽  
Rishi Gupta ◽  
Chung-Huan J Sun ◽  
Coleman Martin ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Acute Stroke ◽  
North American ◽  
Stent Retriever ◽  
Stroke Registry ◽  
Post Marketing

Abstract WP35: Outcomes of Mechanical Embolectomy in Patients Treated Beyond 8 hours From Stroke Onset: a Subanalysis of the North American SOLITAIRE Stent-retriever Acute Stroke Registry

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Alex Abou-Chebl ◽  
Alicia Castonguay ◽  
Franklin A Marden ◽  
Raul G Nogueira ◽  
Robin Novakovic ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Primary Outcome ◽  
Stroke Onset ◽  
Anterior Circulation ◽  
Stroke Registry ◽  
The North ◽  
Primary Endpoints ◽  
Increased Risk ◽  
Stent Retrievers ◽  
Baseline Demographic

Background and Purpose: Endovascular therapy (EVT) with stent-retrievers is safe and effective within 6-8hours of acute ischemic stroke onset; however a large proportion of patients present beyond 8hrs. There is a paucity of data on the safety and effectiveness of EVT in this latter population. Methods: We reviewed demographic, clinical, procedural and clinical outcomes data from consecutive patients treated with the Solitaire™ FR device in the investigator-initiated NASA Registry. Patients were divided into early (≤8hrs) and late (>8hrs) presenting groups. Primary outcomes (90-day mRS 0-2, mortality, and symptomatic ICH) were compared. Results: Three hundred and fifty-four patients from 24 centers were enrolled in NASA. Sixty-three (18%) patients presented >8hrs from onset and were treated. Baseline demographic and procedural factors were comparable between the early and late groups, except for time-to-treatment (271.9±97.3min vs. 754±269.3min, p<0.0001), IV tPA utilization (52.6% vs. 11.1%, <0.0001), baseline diastolic BP (77.9±16.8mmHg vs. 83.8±20.2mmHg, p=0.03), and frequency of vertebrobasilar occlusions (7.1% vs. 19.1%, p=0.0034). Procedural aspects were similar except for time to recanalization (early 73.8±84.5min vs. late 53.6±32min, p=0.0074). Recanalization success (TICI≥2b) was comparable (early 74.4% vs. late 76.2%, p=0.76). The primary outcome measures including symptomatic ICH (11.6% vs. 4.8%, p=0.11), mortality (29.9% vs. 29.3%, p=0.93), and mRS 0-2 (44.4% vs. 34.5%, p=0.17) were similar between the early and late groups, respectively. When only anterior circulation strokes were included (N=301), the data did not change significantly and the primary endpoints of symptomatic ICH (12.1% vs. 5.9%, p=0.2), mortality (27.9% vs. 27.7%, p=0.97) and mRS 0-2 (44.6% vs. 36.2%, p=0.29) remained comparable between the early and late groups, respectively. Conclusions: The NASA Registry has demonstrated that clinical outcomes of patients treated >8hrs from stroke onset are favorable and comparable to the outcomes of patients treated earlier. Later treatment in these selected patients was not associated with an increased risk of symptomatic ICH. Future trials should prospectively evaluate the benefit of EVT beyond 8hrs.

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