{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T13:55:10Z","timestamp":1777730110571,"version":"3.51.4"},"reference-count":18,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Interv Neuroradiol"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>During mechanical thrombectomy for large-vessel occlusions, a ledge effect makes navigating the aspiration catheters (ACs) to the occlusion difficult. New large-bore macrowires minimize this while ensuring flexibility and navigational control. We evaluated the technical feasibility of delivering large-bore ACs to posterior circulation occlusions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective multicenter study evaluated patients treated for posterior circulation strokes with adjunct-free macrowire-only direct aspiration first-pass technique (MO-ADAPT) using 0.024- and 0.035-in macrowires between October 2022 and December 2024. Primary outcomes included successful catheter delivery, successful MO-ADAPT (i.e. adjunct-free catheter delivery and successful clot aspiration), and first-pass reperfusion (i.e. modified thrombolysis in cerebral infarction (mTICI) score\u2009\u2265\u20092b after one MO-ADAPT pass).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 42 included patients (mean age 68.3\u2009\u00b1\u200915.4 years), adjunct-free delivery of ACs to the occlusion using macrowires only was successful in 95.2%. An MO-ADAPT primary approach achieved successful reperfusion in 81.0%, with first-pass reperfusion in 54.8%. Among patients with successful AC delivery, the aspiration success rate was 85.0%. Final mTICI scores of 3, 2c, and 2b after all procedures were seen in 78.6%, 14.3%, and 4.8%, respectively, regardless of thrombectomy method. No vascular complications were observed, and postprocedural intracranial hemorrhage and distal emboli occurred in 2.4% each. A favorable clinical outcome at 90 days was observed in 33.3% of cases. Multivariable analysis showed that underlying intracranial atherosclerotic disease was a negative predictor of both MO-ADAPT success and first-pass reperfusion; no factors predicted AC delivery success.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this retrospective series, MO-ADAPT appeared to be technically feasible for treating posterior circulation strokes, with promising procedural results and a low complication rate. Observed failures were mainly associated with underlying intracranial atherosclerotic disease requiring stent retriever-assisted mechanical thrombectomy. Given the limited sample size and study design, further studies, ideally with larger cohorts and comparative designs, are necessary to clarify the relative safety, efficacy, and cost effectiveness of MO-ADAPT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15910199251386105","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T13:47:41Z","timestamp":1760708861000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["First-pass efficacy with simplicity: Macrowire-only direct aspiration technique in posterior circulation mechanical thrombectomy"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1387-3866","authenticated-orcid":false,"given":"Omid","family":"Shoraka","sequence":"first","affiliation":[{"name":"University of Utah"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward","family":"Seo","sequence":"additional","affiliation":[{"name":"Northwestern University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2056-6610","authenticated-orcid":false,"given":"Ananth K","family":"Vellimana","sequence":"additional","affiliation":[{"name":"Washington University School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad","family":"Khasawneh","sequence":"additional","affiliation":[{"name":"Washington University School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huy M","family":"Do","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hugo H","family":"Cuellar-Saenz","sequence":"additional","affiliation":[{"name":"Louisiana State University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahul","family":"Shah","sequence":"additional","affiliation":[{"name":"Louisiana State University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eytan","family":"Raz","sequence":"additional","affiliation":[{"name":"NYU Langone Health"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayaz M","family":"Khawaja","sequence":"additional","affiliation":[{"name":"NYU Langone Health"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shakeel A","family":"Chowdhry","sequence":"additional","affiliation":[{"name":"NorthShore University Health System"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel R","family":"Calnan","sequence":"additional","affiliation":[{"name":"Penn Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lee A","family":"Birnbaum","sequence":"additional","affiliation":[{"name":"UT Health"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sumeet S","family":"Multani","sequence":"additional","affiliation":[{"name":"Main Line Health"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard T","family":"Dalyai","sequence":"additional","affiliation":[{"name":"ECU Health Neurosurgery and Spine Center, East Carolina University, Greenville, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel A","family":"Tonetti","sequence":"additional","affiliation":[{"name":"Cooper University Health Care"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evan","family":"Joyce","sequence":"additional","affiliation":[{"name":"Saint Alphonsus"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adel M","family":"Malek","sequence":"additional","affiliation":[{"name":"Tufts University School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9000-6083","authenticated-orcid":false,"given":"Ramesh","family":"Grandhi","sequence":"additional","affiliation":[{"name":"University of Utah"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0978-074X","authenticated-orcid":false,"given":"William J","family":"Ares","sequence":"additional","affiliation":[{"name":"NorthShore University Health System"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,10,17]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/15910199221100796"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/15910199221107259"},{"key":"e_1_3_4_4_2","first-page":"159101992312049","article-title":"The Aristotle 18 and 24 microwires in neuroIntervention: early experience at a single centre","author":"Carraro do Nascimento V","year":"2023","unstructured":"Carraro do Nascimento V, de Villiers L, Dhillon PS, et al. The Aristotle 18 and 24 microwires in neuroIntervention: early experience at a single centre. Interv Neuroradiol 2023: 15910199231204923. Online ahead of print.","journal-title":"Interv Neuroradiol"},{"key":"e_1_3_4_5_2","first-page":"159101992413083","article-title":"Macrowire for intracranial thrombectomy: a video description","author":"Kumar AB","year":"2024","unstructured":"Kumar AB, Khan U, Limaye K. Macrowire for intracranial thrombectomy: a video description. Interv Neuroradiol 2024: 15910199241308318. Online ahead of print.","journal-title":"Interv Neuroradiol"},{"key":"e_1_3_4_6_2","article-title":"Aristotle-only direct aspiration first-pass technique (AO-ADAPT) for endovascular mechanical thrombectomy: a technical series of a novel technique demonstrating safety and efficacy","volume":"4","author":"Ares WJ","year":"2024","unstructured":"Ares WJ, Chowdhry S, Tonetti DA, et al. Aristotle-only direct aspiration first-pass technique (AO-ADAPT) for endovascular mechanical thrombectomy: a technical series of a novel technique demonstrating safety and efficacy. Stroke Vasc Interv Neurol 2024; 4: e001069.","journal-title":"Stroke Vasc Interv Neurol"},{"key":"e_1_3_4_7_2","first-page":"159101992412994","article-title":"Early experience with the Aristotle Colossus 0.035\u2019 macrowire for mechanical thrombectomy in 30 consecutive cases","author":"Zarrin DA","year":"2024","unstructured":"Zarrin DA, Laghari FJ, Campos JK, et al. Early experience with the Aristotle Colossus 0.035\u2019 macrowire for mechanical thrombectomy in 30 consecutive cases. Interv Neuroradiol 2024: 15910199241299480. 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Stroke Vasc Interv Neurol 2024; 4: e001384.","journal-title":"Stroke Vasc Interv Neurol"},{"key":"e_1_3_4_15_2","unstructured":"US Food and Drug Administration. 510(k) clearance for Aristotle 24 guidewire: K192783 https:\/\/www.accessdata.fda.gov\/scripts\/cdrh\/cfdocs\/cfpmn\/pmn.cfm?ID=K192783 (30 October 2019 accessed 15 May 2025)."},{"key":"e_1_3_4_16_2","unstructured":"US Food and Drug Administration. 510(k) clearance for Aristotle Colossus guidewire: K222437 https:\/\/www.accessdata.fda.gov\/scripts\/cdrh\/cfdocs\/cfpmn\/pmn.cfm?ID=K222437 (26 January 2023 accessed 15 May 2025)."},{"key":"e_1_3_4_17_2","first-page":"159101992412492","article-title":"Optimizing catheter centering enhances mechanical thrombectomy success: performance difference in cases using novel macrowires versus traditional microwires","author":"Hassan AE","year":"2024","unstructured":"Hassan AE, Tekle WG, Saei H. 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