Background and purpose Expandable stents have broadened the spectrum of endovascular treatment of intracranial aneur- ysms. The Neuroform ATLAS, a nitinol self-expanding, hybrid/open-cell stent, is the evolution of the Neuroform EZ supposing to ease the navigability of the system into intra-cra- nial arteries, through a low-profile 0.017 inch delivery cathe- ter. We present herein our initial experience in the treatment of intracranial aneurysms with this novel stent. Materials and methods We compiled data from consecutive patients of our institution from July 2015 to Avril 2016 who underwent stent-assisted coiling with the Neuroform ATLAS. Clinical and angiographic results were analyzed retrospectively. Results Twenty-seven intracranial saccular aneurysms (12 MCA, 9 AcoA, 4 ICA bifurcation, 1 basilar tip, 1 vertebral-PICA) in 26 patients (17 women, 9 men, mean age 59 years) were consecu- tively treated. The stent was used in 23 previously untreated aneurysms, and in 4 cases of recanalization. One single stent was used in 11 aneurysms while 16 aneurysms were treated with 2 stents in a “Y” configuration. The immediate post-treatment angiography showed a complete occlusion in 11 cases (40.7%), a residual neck in 3 cases (11.1%) and a residual aneurysmal con- trast filling in 13 cases (48.1%). Two complications occurred (7.4%), the first due to an associated aneurysm perforation (mRs 2), and the second due to parent vessel perforation (mRs 6). Both of them occurred after the stent implantation. Conclusion The Neuroform ATLAS Delivery System is an effective device for treatment of complex intracranial aneur- ysms, allowing good conformability and stability with a high level of navigability. Disclosures G. Ciccio: None. S. Smajda: None. T. Robert: None. H. Redjem: None. R. Blanc: None. C. Ruiz Guerrero: None. J. Desilles: None. H. Takezawa: None. P. Sasannejad: None. M. Piotin: None. Electronic Poster Abstracts E-001 COMPARISON OF CLINICAL OUTCOMES IN PATIENTS WITH ANTERIOR CIRCULATION ACUTE ISCHEMIC STROKES TREATED WITH MECHANICAL THROMBECTOMY USING THE ADAPT TECHNIQUE ONLY VERSUS ADAPT WITH SOLUMBRA SALVAGE 1J Delgado Almandoz, 1Y Kayan, 2M Young, 1J Fease, 1J Scholz, 1A Milner, 2P Roohani, 2T Hehr, 3M Mulder, 2R Tarrel. 1Neurointerventional Radiology, Abbott Northwestern Hospital, Minneapolis, MN; 2Vascular Neurology, Abbott Northwestern Hospital, Minneapolis, MN; 3Critical Care Medicine, Abbott Northwestern Hospital, Minneapolis, MN 10.1136/neurintsurg-2016-012589.73 Purpose To compare procedural and clinical outcomes in patients with anterior circulation acute ischemic strokes treated with mechanical thrombectomy using ADAPT technique only or ADAPT with Solumbra salvage. Materials and methods We restrospectively reviewed a consecu- tive cohort of patients with anterior circulation acute ischemic strokes treated with mechanical thrombectomy using ADAPT technique only or ADAPT with Solumbra salvage at our insti- tution between March 11th, 2013 and December 31st, 2015. Baseline clinical and radiological characteristics and procedural variables were recorded. Clinical outcomes at 90 days were recorded using the modified Rankin Scale (mRS). Results Fifty-nine patients were included, 33 male (56%). Mean age 67.1 years, mean admission NIHSS 19.1. Forty-six patients were treated with ADAPT only (78%) and 13 with ADAPT with Solumbra salvage (22%). Table 1 summarizes baseline clinical and radiological characteristics. There was a trend towards a higher proportion of patients with ICA termi- nus thrombi in the ADAPT with Solumbra salvage group (69.2%, p-value 0.054). Table 2 summarizes the procedural variables. There was a significantly-lower mean time from puncture to reperfusion in the ADAPT only group (29.5 minutes) compared to the ADAPT with Solumbra salvage group (85.1 minutes, p-value < 0.001). There was a signifi- cantly-higher number of mean thrombectomy device passes in the ADAPT with Solumbra salvage group (5.6) compared to the ADAPT only group (2.3, p-value 0.005). There are a sig- nificantly-higher rate of iatrogenic cervical vascular dissection in the ADAPT with Solumbra salvage group (15%) compared to the ADAPT only group (0, p-value 0.046). Table 3 summa- rizes the clinical outcomes. There was a significantly-higher rate of unfavorable clinical outcome (mRS 4–6) and death at 90 days in the ADAPT with Solumbra salvage group (61.5% and 38.5%, respectively) compared to the ADAPT only group Abstract E-001 Table 1 Baseline clinical and radiological characteristics All patients (n = 59) ADAPT only (n = 46) ADAPT with solumbra salvage (n = 13) p- value Mean age, years 67.1 67.3 66.5 0.8 Admission NIHSS 19.1 19.1 19.2 1 iv-tPA 56% 59% 47% 0.5 Atrial fibrillation 39% 37% 46% 0.8 Male Sex 56% 57% 54% 1 Mean NCCT ASPECTS 9.1 9.1 9.2 0.9 M1 Thrombus 46% 50% 31% 0.4 ICA terminus thrombus 42% 35% 69% 0.054 Severe tortuosity (�360 degrees) 31% 28% 39% 0.5 Abstract E-001 Table 2 Procedural variables All patients (n = 59) ADAPT only (n = 46) ADAPT with solumbra salvage (n = 13) p- value Number of devices passes 3.1 2.3 5.6 0.005 5 Max ACE use 70% 63% 92% 0.084 ACE 64 use 30% 37% 8% 0.084 TICI 2 b/3 reperfusion 90% 91% 85% 0.6 Carotid stent deployment 12% 13% 8% 1 Embolus to new territory 5% 4% 8% 1 Iatrogenic cervical dissection 3% 0 15% 0.046 Puncture to Reperfusion, minutes 41.7 29.5 85.1 0.0001 Last Known Well to Reperfusion, minutes 271 259 316 0.17 Electronic Poster Abstracts A44 JNIS 2016;8(1):A1–A100 (28.3% and 10.9%, p-value 0.047 and 0.033, respectively). There was a trend towards a higher rate of favorable clinical outcomes (mRS 0–2) at 90 days in the ADAPT only group (54%) compared to the ADAPT with Solumbra salvage group (31%, p-value 0.21). Conclusion Among patients treated with mechanical thrombec- tomy using an ADAPT-first approach, those requiring Solum- bra salvage had significantly-higher rates of unfavorable clinical outcome and death at 90 days. Abstract E-001 Table 3 Clinical outcomes All patients (n = 59) ADAPT only (n = 46) ADAPT with solumbra salvage (n = 13) p- value Symptomatic intraparenchymal hemorrhage 1.7% 2.2% 0 1 Symptomatic subarachnoid h 1.7% 0 7.7% 0.22 Neuro-ICU length of stay, days 3.1 2.6 4.6 0.11 Hospital length of stay, days 6.6 6.2 8 0.22 Discharge to home: 22% 26% 8% 0.26 In-Hospital Mortality / Discharge to Hospice 14% 9% 31% 0.06 90 day Mortality 17% 11% 39% 0.033 90 day mRS 4–6 36% 28% 62% 0.047 90 day mRS 0–2 49% 54% 31% 0.21 Disclosures J. Delgado Almandoz: 2; C; Medtronic Neurovas- cular, Penumbra, Inc. Y. Kayan: 2; C; Medtronic Neurovascu- lar, Penumbra, Inc. M. Young: None. J. Fease: None. J. Scholz: None. A. Milner: None. P. Roohani: None. T. Hehr: None. M. Mulder: None. R. Tarrel: None. E-002 PROLONGATION OF POLYMETHYLMETHACRYLATE CEMENT WORKING TIME DURING PERCUTANEOUS KYPHOPLASTY WITH ICE BATH COOLING B Kim. Texas Stroke Institute, Plano, TX 10.1136/neurintsurg-2016-012589.74 Aim To study the effect of cooling of polymethylmethacrylate dough in an ice bath to prolong working time of cement dur- ing percutaneous kyphoplasty. Materials and methods Polymethylmethacrylate dough filled cement cartridges were placed in a saline ice bath for varying lengths of time to study the effect of cooling cartridges on working time of cement during percutaneous kyphoplasty using the Kyphon® (Medtronic Spine, Sunnyvale, CA, USA) Balloon Kyphoplasty system. Results Cement dough was easily injectable through the bone filler with the injection gun immediately after removal from an ice bath at 15, 30, and 60 minutes of storage. Consistency of the mixture was ideally doughy at all time points. After 15 minutes at room temperature, the mixture continued to be injectable with slightly more resistance at these time points. The mixture was more firm yet maintained a doughy consis- tency. Cement dough could not be injected after 120 minutes of storage, either immediately after removal or after 15 minutes at room temperature. Conclusion We demonstrate the prolongation of working time of polymethylmethacrylate cement in percutaneous kyphoplasty using ice bath cooling of dough filled cement cartridges. Cement dough was injectable after storage in an ice bath for up to 60 minutes. In the clinical setting, intraprocedual cool- ing using this simple, low cost technique may extend the working time of polymethylmethacrylate for the operator and may improve the utility of a single Balloon Kyphoplasty kit when treating multiple vertebral compression fractures. Disclosures B. Kim: None. E-003 EVALUATION OF STRATEGIES TO REDUCE TIME TO REVASCULARIZATION IN ACUTE ISCHEMIC STROKE 1A Doerr, 2S Jenkins, 3J Davis. 1Northwestern Medicine, Chicago, IL; 2Mennonite College of Nursing, Illinois State University, Normal, IL; 3Central DuPage Hospital, Winfield, IL 10.1136/neurintsurg-2016-012589.75 Background Stroke is significant cause of morbidity, disability and mortality in the United States today. There is growing support for the need for process improvement, specifically, reducing time to reperfusion in endovascular stroke therapy (EVT) to improve functional outcomes. It is suggested that every 30 minutes delay in revascularization of acute ischemic stroke leads to a 10.6% decrease in the potential for a good functional outcome (Khatri et al., 2009). Purpose To identify the impact on specific hospital based proc- ess improvement strategies in the acute ischemic stroke patient population undergoing endovascular therapy with specific intent to decrease median arrival to revascularization time, thus increasing the potential for good functional outcome. We Abstract E-002 Figure 1 Electronic Poster Abstracts JNIS 2016;8(1):A1–A100 A45