{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T19:19:46Z","timestamp":1789154386035,"version":"build-2803163510"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","funder":[{"name":"CERENOVUS\/Johnson & Johnson"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>The EXCELLENT registry aimed to evaluate the effectiveness of the EMBOTRAP Revascularization Device in an all-comer population in a real-world setting, with a focus on the composition of retrieved clots.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>EXCELLENT is a prospective, global registry of patients with acute ischemic stroke treated with EMBOTRAP as the first-line mechanical thrombectomy device conducted at 34 sites (25 sites contributing clot) from September 2018 to March 2021, utilizing core imaging and central histology laboratories blinded to clinical data, independent 90-day modified Rankin Scale assessment and Clinical Events Committee.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              After screening 3799 patients, a total of 997 subjects (mean age, 70.0\u00b114.2 years; 51.8% women; 19.7% non-White) were included. The first-pass modified Treatment in Cerebral Infarction (mTICI) \u22652b rate was 64.5% (623\/966), first-pass mTICI \u22652c was 39.1% (378\/966), and final mTICI \u22652b was 94.5% (931\/985). A total of 427\/912 (46.8%) patients achieved a 90-day modified Rankin Scale of 0 to 2 or \u2264baseline. Embolization to a new territory occurred in 0.2% (2\/984), and symptomatic intracranial hemorrhage at 24 hours in 1.6% (16\/997). The 90-day mortality was 19.1% (175\/918). Device- and\/or procedure-related serious adverse events occurred in 5.9% (54\/912) through 90 days. The mean RBC percentage of retrieved clots was 45.62\u00b121.372. Among patients who achieved mTICI \u22652b with the first pass, 15.7% (52\/331) and 9.7% (32\/331), respectively, had RBC-poor (&lt;25%) and RBC-rich (&gt;75%) clots. Patients with no clot retrieved in any procedural pass had a lower percentage of hyperdense or susceptibility vessel sign on baseline imaging (58.9% versus 74.7%;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001), pointing to a potential preprocedure indicator of challenging clot.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>The EXCELLENT registry informs real-world practices in mechanical thrombectomy and sheds light on the range of clots effectively retrieved by current technology. This is the first report of detailed patient characteristics where mechanical thrombectomy maneuvers failed to remove any clot material. Although the composition of nonretrievable clots cannot be assessed histologically, the results support the notion that no retrieval may be correlated with imaging findings suggesting clots lower in RBC.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>REGISTRATION:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT03685578.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.124.047324","type":"journal-article","created":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T10:00:30Z","timestamp":1732010430000},"page":"2804-2814","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["EXCELLENT Registry: A Prospective, Multicenter, Global Registry of Endovascular Stroke Treatment With the EMBOTRAP Device"],"prefix":"10.1161","volume":"55","clinical-trial-number":[{"clinical-trial-number":"nct03685578","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4532-153X","authenticated-orcid":true,"given":"Raul G.","family":"Nogueira","sequence":"first","affiliation":[{"name":"Department of Neurology and Neurosurgery, University of Pittsburgh Medical Center (UPMC) Stroke Institute, University of Pittsburgh School of Medicine, PA (R.G.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8202-7829","authenticated-orcid":true,"given":"Tommy","family":"Andersson","sequence":"additional","affiliation":[{"name":"Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden (T.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1884-2196","authenticated-orcid":true,"given":"Diogo C.","family":"Haussen","sequence":"additional","affiliation":[{"name":"Grady Memorial Hospital, Atlanta, GA (D.C.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7657-142X","authenticated-orcid":true,"given":"Albert J.","family":"Yoo","sequence":"additional","affiliation":[{"name":"Texas Stroke Institute, Dallas-Fort Worth (A.J.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7195-5806","authenticated-orcid":true,"given":"Ricardo A.","family":"Hanel","sequence":"additional","affiliation":[{"name":"Baptist Neurological Institute, Jacksonville, FL (R.A.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4881-4698","authenticated-orcid":true,"given":"Osama O.","family":"Zaidat","sequence":"additional","affiliation":[{"name":"Mercy Health St. Vincent Medical Center, Toledo, OH (O.O.Z.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6951-6182","authenticated-orcid":true,"given":"Werner","family":"Hacke","sequence":"additional","affiliation":[{"name":"Ruprecht-Karl University of Heidelberg, Germany (W. Hacke)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2619-6975","authenticated-orcid":true,"given":"Tudor G.","family":"Jovin","sequence":"additional","affiliation":[{"name":"Cooper University Hospital, Camden, NJ (T.G.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8533-7478","authenticated-orcid":true,"given":"Jens","family":"Fiehler","sequence":"additional","affiliation":[{"name":"University Medical Center Hamburg-Eppendorf, Germany (J.F., C.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1807-5882","authenticated-orcid":true,"given":"Simon F.","family":"De Meyer","sequence":"additional","affiliation":[{"name":"KU Leuven, Kortrijk, Belgium (S.F.D.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5271-5524","authenticated-orcid":true,"given":"Waleed","family":"Brinjikji","sequence":"additional","affiliation":[{"name":"Mayo Clinic, Rochester, MN (W.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8984-6296","authenticated-orcid":true,"given":"Karen M.","family":"Doyle","sequence":"additional","affiliation":[{"name":"Department of Physiology and Science Foundation Ireland Research Centre for Medical Devices (CURAM-SFI) Research Centre for Medical Devices, University of Galway, Ireland (K.M.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David F.","family":"Kallmes","sequence":"additional","affiliation":[{"name":"Department of Radiology, Mayo Clinic, Rochester, MN (D.F.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5109-8736","authenticated-orcid":true,"given":"David S.","family":"Liebeskind","sequence":"additional","affiliation":[{"name":"University of California Los Angeles (D.S.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1879-0015","authenticated-orcid":true,"given":"Renu","family":"Virmani","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Pathology, CV Path Institute, Gaithersburg, MD (R.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malgosia A.","family":"Kokoszka","sequence":"additional","affiliation":[{"name":"Cerenovus (Johnson &amp; Johnson), Irvine, CA (M.A.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0399-3346","authenticated-orcid":true,"given":"Violiza","family":"Inoa","sequence":"additional","affiliation":[{"name":"University of Tennessee Health Science Center, Memphis (V.I.)."},{"name":"Semmes-Murphey Clinic, Memphis, TN (V.I.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Humphries","sequence":"additional","affiliation":[{"name":"Wellstar Health System, Kennestone Hospital, Marietta, GA (W. Humphries)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith B.","family":"Woodward","sequence":"additional","affiliation":[{"name":"Fort Sanders Regional Medical Center, Knoxville, TN (K.B.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8965-2413","authenticated-orcid":true,"given":"Pascal M.","family":"Jabbour","sequence":"additional","affiliation":[{"name":"Thomas Jefferson University Hospital, Philadelphia, PA (P.M.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Fran\u00e7ois","sequence":"additional","affiliation":[{"name":"AZ Groeninge, Kortrijk, Belgium (O.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6208-3724","authenticated-orcid":true,"given":"Elad I.","family":"Levy","sequence":"additional","affiliation":[{"name":"University at Buffalo, State University of New York (E.I.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hormozd","family":"Bozorgchami","sequence":"additional","affiliation":[{"name":"Oregon Health and Sciences University, Portland (H.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4094-8069","authenticated-orcid":true,"given":"Stephan","family":"Boor","sequence":"additional","affiliation":[{"name":"University Medical Center of the Johannes Gutenberg University Mainz, Germany (S.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8953-7634","authenticated-orcid":true,"given":"Jose E.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Hadassah University Medical Center, Jerusalem, Israel (J.E.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1552-9738","authenticated-orcid":true,"given":"Shervin R.","family":"Dashti","sequence":"additional","affiliation":[{"name":"Billings Clinic, MT (S.R.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad A.","family":"Taqi","sequence":"additional","affiliation":[{"name":"Los Robles Hospital and Medical Center, Thousand Oaks, CA (M.A.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald F.","family":"Budzik","sequence":"additional","affiliation":[{"name":"Riverside Methodist Hospital, Columbus, OH (R.F.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1743-8781","authenticated-orcid":true,"given":"Clemens M.","family":"Schirmer","sequence":"additional","affiliation":[{"name":"Geisinger Health System, Danville, PA (C.M.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Shazam","family":"Hussain","sequence":"additional","affiliation":[{"name":"Cleveland Clinic, OH (M.S.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9010-7447","authenticated-orcid":true,"given":"Laurent","family":"Estrade","sequence":"additional","affiliation":[{"name":"Lille University Hospital, France (L.E.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9447-5338","authenticated-orcid":true,"given":"Reade A.","family":"De Leacy","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai, New York, NY (R.A.D.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajit S.","family":"Puri","sequence":"additional","affiliation":[{"name":"University of Massachusetts, Worcester (A.S.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8591-8854","authenticated-orcid":true,"given":"Rohan V.","family":"Chitale","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center, Nashville, TN (R.V.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6428-2156","authenticated-orcid":true,"given":"Caspar","family":"Brekenfeld","sequence":"additional","affiliation":[{"name":"University Medical Center Hamburg-Eppendorf, Germany (J.F., C.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9519-0059","authenticated-orcid":true,"given":"Adnan H.","family":"Siddiqui","sequence":"additional","affiliation":[{"name":"University at Buffalo Jacobs School of Medicine and Biomedical Sciences, NY (A.H.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00163-X"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)01341-6"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.010867"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k949"},{"key":"e_1_3_3_6_2","article-title":"The Society of Vascular and Interventional Neurology (SVIN) mechanical thrombectomy registry: methods and primary results.","volume":"2","author":"Haussen DC","year":"2022","unstructured":"Haussen DC, Al\u2010Bayati AR, Mohammaden MH, Sheth SA, Salazar\u2010Marioni S, Linfante I, Dabus G, Starosciak AK, Hassan AE, Tekle WG, et al. The Society of Vascular and Interventional Neurology (SVIN) mechanical thrombectomy registry: methods and primary results. Stroke Vasc Intervent Neurol. 2022;2.","journal-title":"Stroke Vasc Intervent Neurol"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000011096"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.117.016456"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2118191"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2213379"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2214403"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)02032-9"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2206317"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2207576"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)00575-5"},{"key":"e_1_3_3_16_2","article-title":"Randomization of endovascular treatment with stent-retriever and\/or thromboaspiration vs. best medical therapy in acute ischemic stroke due to large vessel occlusion trial in the extended time window (RESILIENT-EXTEND): a trial of extended window thrombectomy without advanced imaging in a developing country.","author":"Nogueira RG","year":"2024","unstructured":"Nogueira RG, Mont\u2019Alverne F, Cabral L. Randomization of endovascular treatment with stent-retriever and\/or thromboaspiration vs. best medical therapy in acute ischemic stroke due to large vessel occlusion trial in the extended time window (RESILIENT-EXTEND): a trial of extended window thrombectomy without advanced imaging in a developing country. International Stroke Conference. 2024.","journal-title":"International Stroke Conference"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2021-017671"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1159\/000480668"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2018-014601"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0225841"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.001972"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.010049"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1159\/000486042"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.121.034289"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.110.605576"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.032810"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.5853\/jos.2021.01375"}],"updated-by":[{"DOI":"10.1161\/str.0000000000000488","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T00:00:00Z","timestamp":1737936000000}}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.124.047324","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T14:53:46Z","timestamp":1748530426000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.124.047324"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12]]},"references-count":26,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1161\/STROKEAHA.124.047324"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.124.047324","relation":{"correction":[{"id-type":"doi","id":"10.1161\/STR.0000000000000488","asserted-by":"object"}]},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12]]},"assertion":[{"value":"2024-03-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-31","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}