{
  "abstract": "Background\n\nEndovascular thrombectomy is increasingly performed for acute ischemic stroke due to medium vessel occlusion (MeVO); however, recent randomized trials-primarily using stent retriever (SR) techniques-have not demonstrated a clear benefit over medical management. This study aimed to compare the direct aspiration first-pass technique (ADAPT) and SR in MeVO using a multicenter endovascular thrombectomy consortium.Methods\n\nThe Society of Vascular and Interventional Neurology registry was queried for all primary MeVO cases treated with ADAPT or SR as the first-pass technique. MeVO was defined as an occlusion of A1, P1, M2, or beyond. Outcomes included time to recanalization, recanalization rates, first-pass effect (defined as Treatment in Cerebral Infarction-3 after first pass), intracranial hemorrhage, symptomatic intracranial hemorrhage, and clinical outcomes.Results\n\nA total of 1391 patients with MeVO were identified; 415 (29.8%) in the ADAPT group and 976 (70.2%) in the SR group. The most common location of occlusion was the middle cerebral artery-M2 (75.9%), followed by the middle cerebral artery-M3 (11.4%). The median age was 70, and 698 (50.4%) patients were men. Time from angio-suite arrival to expanded Treatment in Cerebral Infarction (eTICI) ≥2b (54 versus 60, P=0.002), time from endovascular access to final recanalization (42 versus 52, P<0.001), time from endovascular access to eTICI 2b (31 versus 39, P<0.001), and eTICI 3 (26 versus 34, P<0.001) were shorter for the ADAPT group. Conversely, the SR group had higher rates of eTICI ≥2b (91.6% versus 86.3%, P=0.002) and first-pass effect (31.7% versus 23.4%, P=0.002). Rates of good outcome, excellent outcome, intracranial hemorrhage, and sICH were not significantly different between groups.Conclusions\n\nAlthough ADAPT yielded faster recanalization, SR achieved a higher first-pass effect and slightly higher recanalization rates. Intracranial hemorrhage, symptomatic intracranial hemorrhage, and clinical outcomes were comparable between groups. This study suggests that both techniques may offer distinct advantages. Prospective randomized controlled studies are warranted to further understand the safety and efficacy of ADAPT versus the SR technique in patients with MeVO.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Neurosurgery, Mount Sinai Health System, New York, NY (S. Matsoukas, A.M., J.T.F., J.M., S. Majidi).",
    "Department of Neurology, UT Health McGovern Medical School, Houston, TX (S.A.S., A.I., J.N.S.).",
    "Department of Neurology, Grady Health System Marcus Stroke and Neuroscience Center, Atlanta, GA (D.C.H., J.D., J.A.G., M.H.M.).",
    "Department of Neuroscience, Valley Baptist Medical Center-Harlingen, TX (A.E.H., W.G.T., S.M., H.M.S.).",
    "Department of Neurology, Neurosurgery and Radiology, University of Iowa Hospitals and Clinics, Iowa City (S.O.-G., M.G.-C., J.C., L.C.-C.).",
    "Department of Neurology, Cooper Neurological Institute, Cooper University Health Care, Camden, NJ (M.J.D., L.Z., J.K.).",
    "Department of Radiology, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA (M.A., P.K.).",
    "Department of Neurosurgery, Baptist Health Miami Neuroscience Institute, FL (G.D., I.L.).",
    "Memorial Neuroscience Institute, Pembroke Pines, FL (B.P.M., J. Sessa).",
    "Department of Neurology, ProMedica Toledo Hospital, OH (M.A.J.).",
    "Department of Neurology, University of South Alabama, Mobile (T.N.).",
    "Department of Neurology, Souers Stroke Institute, Saint Louis University School of Medicine, MO (G.L.).",
    "Department of Neurology and Neurosurgery, University of Pittsburgh Medical Center Stroke Institute, University of Pittsburgh School of Medicine, PA (A.R.A.-B., R.G.N.).",
    "Department of Neurology, David Geffen School of Medicine (DGSOM), University of California, Los Angeles (D.S.L.)."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 35,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Stavros Matsoukas",
      "orcid": "0000-0001-5902-0637"
    },
    {
      "affs": [
        0
      ],
      "name": "Amol Mehta",
      "orcid": "0000-0002-1343-7389"
    },
    {
      "affs": [
        0
      ],
      "name": "Johanna T Fifi",
      "orcid": "0000-0001-7786-5668"
    },
    {
      "affs": [
        0
      ],
      "name": "J Mocco",
      "orcid": "0000-0001-5489-2524"
    },
    {
      "affs": [
        1
      ],
      "name": "Sunil A Sheth",
      "orcid": "0000-0003-0602-8509"
    },
    {
      "affs": [
        1
      ],
      "name": "Ananya Iyyangar",
      "orcid": "0009-0005-8048-3296"
    },
    {
      "affs": [
        1
      ],
      "name": "Joseph Naji Samaha",
      "orcid": "0009-0004-9964-2325"
    },
    {
      "affs": [
        2
      ],
      "name": "Diogo C Haussen",
      "orcid": "0000-0003-1884-2196"
    },
    {
      "affs": [
        2
      ],
      "name": "Jaydevsinh Dolia",
      "orcid": "0000-0002-3924-047X"
    },
    {
      "affs": [
        2
      ],
      "name": "Jonathan A Grossberg",
      "orcid": "0000-0002-1152-8826"
    },
    {
      "affs": [
        2
      ],
      "name": "Mahmoud H Mohammaden",
      "orcid": "0000-0002-7393-9989"
    },
    {
      "affs": [
        3
      ],
      "name": "Ameer E Hassan",
      "orcid": "0000-0002-7148-7616"
    },
    {
      "affs": [
        3
      ],
      "name": "Wondwossen G Tekle",
      "orcid": "0000-0001-5556-5699"
    },
    {
      "affs": [
        3
      ],
      "name": "Samantha Miller",
      "orcid": "0000-0001-9851-8622"
    },
    {
      "affs": [
        3
      ],
      "name": "Hamzah M Saei"
    },
    {
      "affs": [
        4
      ],
      "name": "Santiago Ortega-Gutierrez",
      "orcid": "0000-0002-3408-1297"
    },
    {
      "affs": [
        4
      ],
      "name": "Milagros Galecio-Castillo",
      "orcid": "0000-0002-8107-9632"
    },
    {
      "affs": [
        4
      ],
      "name": "Jorge Cespedes",
      "orcid": "0000-0001-9826-7077"
    },
    {
      "affs": [
        4
      ],
      "name": "Leonardo Cruz-Criollo",
      "orcid": "0009-0007-6751-9463"
    },
    {
      "affs": [
        5
      ],
      "name": "Michael J Dubinski",
      "orcid": "0009-0008-7112-9975"
    },
    {
      "affs": [
        5
      ],
      "name": "Linda Zhang"
    },
    {
      "affs": [
        5
      ],
      "name": "Jane Khalife",
      "orcid": "0000-0003-3662-3886"
    },
    {
      "affs": [
        6
      ],
      "name": "Mohamad Abdalkader",
      "orcid": "0000-0002-9528-301X"
    },
    {
      "affs": [
        6
      ],
      "name": "Piers Klein",
      "orcid": "0000-0001-7468-137X"
    },
    {
      "affs": [
        7
      ],
      "name": "Guilherme Dabus",
      "orcid": "0000-0003-1582-6035"
    },
    {
      "affs": [
        7
      ],
      "name": "Italo Linfante",
      "orcid": "0000-0001-8973-4294"
    },
    {
      "affs": [
        8
      ],
      "name": "Brijesh P Mehta",
      "orcid": "0000-0001-8332-2299"
    },
    {
      "affs": [
        8
      ],
      "name": "Joy Sessa",
      "orcid": "0009-0009-6649-7287"
    },
    {
      "affs": [
        9
      ],
      "name": "Mouhammad A Jumma",
      "orcid": "0000-0002-7165-797X"
    },
    {
      "affs": [
        10
      ],
      "name": "Taha Nisar"
    },
    {
      "affs": [
        11
      ],
      "name": "Guillermo Linares",
      "orcid": "0000-0001-8694-2645"
    },
    {
      "affs": [
        12
      ],
      "name": "Alhamza R Al-Bayati",
      "orcid": "0000-0001-8103-1930"
    },
    {
      "affs": [
        12
      ],
      "name": "Raul G Nogueira",
      "orcid": "0000-0003-4532-153X"
    },
    {
      "affs": [
        13
      ],
      "name": "David S Liebeskind",
      "orcid": "0000-0002-5109-8736"
    },
    {
      "affs": [
        0
      ],
      "name": "Shahram Majidi",
      "orcid": "0000-0003-2971-6216"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6gsah6rqf2qax.bib",
  "cited_by": 0,
  "doi": "10.1161/svin.125.001950",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13727254/?tool=EBI",
  "id": "6gsah6rqf2qax",
  "issns": [
    "2694-5746"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13727254",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "10173"
    ],
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2713|Acute Ischemic Stroke Management"
    ]
  ],
  "openalex": "W7214199811",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13727254/pdf/?tool=EBI",
  "pmcid": "PMC13727254",
  "pmid": "42974627",
  "published": "2026-09-24",
  "publisher": "Wolters Kluwer Health",
  "ris": "https://research.draconitic.com/paper/6gsah6rqf2qax.ris",
  "sources": [
    {
      "first_seen": "2026-11-03T15:20:51Z",
      "native_id": "PMC:PMC13727254",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13727254"
    },
    {
      "first_seen": "2026-11-04T15:20:49Z",
      "native_id": "MED:42974627",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42974627"
    },
    {
      "first_seen": "2026-11-05T12:23:22Z",
      "native_id": "PMC13727254",
      "source": "pmc",
      "url": "https://doi.org/10.1161/svin.125.001950"
    }
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Acute Ischemic Stroke Management",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Outcomes Following First-Pass Direct Aspiration Versus Stent Retriever for Endovascular Thrombectomy in Primary Medium or Distal Vessel Occlusion: An Analysis of the SVIN Registry",
  "title_text": "Outcomes Following First-Pass Direct Aspiration Versus Stent Retriever for Endovascular Thrombectomy in Primary Medium or Distal Vessel Occlusion: An Analysis of the SVIN Registry",
  "type": "peer-reviewed",
  "updated_at": "2026-11-06T12:22:58Z",
  "url": "https://research.draconitic.com/paper/6gsah6rqf2qax",
  "venue": "Stroke (Hoboken, N.J.)",
  "versions": []
}