Jadhav AP, Desai SM, Zaidat OO, et al. - In this analysis of a large real-world cohort of patients (Systematic Evaluation of Patients Treated with Stroke Devices for Acute Ischemic Stroke registry), first pass effect (FPE) and modified FPE were shown to be related to superior clinical outcomes.

• In cases of acute ischemic stroke secondary to large vessel occlusion, achieving complete revascularization after a single pass of a mechanical thrombectomy device (FPE) is related to good clinical results.

• In this study with 930 patients, FPE was achieved in 40.5% of patients and multiple passes (MP) in 20.0%.

• Fewer internal carotid artery occlusions were present in the FPE group vs MP.

• In the FPE group, there was faster puncture to recanalization time, higher rates of 90-day modified Rankin Scale (mRS) score of 0 to 1 (52.6% vs 38.6%), mRS score of 0 to 2 (65.4% vs 52.0%), and lower 90-day mortality than the MP group (12.0% vs 18.7%).

• Similarly, relative to modified MP patients, there were fewer internal carotid artery occlusions, faster puncture to recanalization time, and higher rates of 90-day mRS score of 0 to 1 and mRS score of 0 to 2 in the modified FPE group.