Abstract 390: Real‐world evaluation of endovascular stroke treatment using stent retrievers with drop zone technology ‐ insights from a single center study

Background The NeVa stent retriever with drop zone technology for treating acute ischemic stroke (AIS) due to large vessel occlusions (LVOs) has demonstrated safety and effectiveness in a previously completed prospective, multicenter, quality controlled, Food and Drug Administration (FDA)‐regulated clinical study (CLEAR) in highly selected sites and patients. Objective To evaluate the safety and effectiveness of revascularizing acute LVOs using the NeVa or NeVa NET devices in a real‐world setting. Methods This retrospective, single‐center, single‐arm study aimed to assess the safety and performance of the NeVa device in revascularizing LVOs in the anterior circulation within 24 hours of stroke onset. Occlusion locations included the internal carotid artery (ICA) and the M1/M2 branches of the middle cerebral artery (MCA). The primary endpoint was rate of expanded Treatment in Cerebral Ischemia (eTICI) score of 2b‐3 within 3 NeVa passes. Other key endpoints included first pass success (eTICI 2c‐3) and final reperfusion success (eTICI 2b‐3). Safety endpoint was 24‐hour symptomatic intracranial hemorrhage (sICH). Results Between December 2021 and June 2024, 96 patients were treated using a NeVa stent retriever. The occlusion sites included the distal ICA (n=5), carotid‐T (n=20), MCA‐M1 (n=53), and MCA‐M2 (n=18). Successful reperfusion (eTICI 2b‐3) within 3 passes was achieved in 85.4% (82/96) of cases. First pass success of eTICI 2b‐3 was achieved in 49.0% (47/96) of patients, with eTICI 2b67‐3 in 47.9% (46/96), and eTICI 2c‐3 in 43.8% (42/96). The final reperfusion rate (eTICI 2b‐3), including bail‐out strategies or other devices, was 91.6% (88/96); final eTICI 2b67‐3 rate was 83.3% (80/96), and final eTICI 2c‐3 rate was 75.0% (72/96). The median number of passes was 1 (IQR 1‐2). The rate of sICH was 5.2% (5/96). Three month clinical outcomes will be available at the time of the annual meeting. Conclusions The NeVa devices displayed high effectiveness in achieving revascularization. The results were comparable to previous studies, although patient variability and procedural differences may affect results and potentially outcomes.