- Cohort I:
1. Inability to obtain written informed consent.
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2. Patient is \< 21 or \> 85 years of age.
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3. Patient has a pre-morbid mRS = 2.
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4. More than 8 hours have passed since symptom onset.
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5. Severe unilateral or bilateral carotid artery stenosis or dissection requiring stent treatment.
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6. Presence of a pre-existing large territory infarction.
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7. Absent femoral pulses or other condition preventing femoral access.
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8. Patient has vascular anatomy/tortuosity or other vascular disease preventing access to the target occlusion or that will likely result in unstable access.
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10. Known or suspected pre-existing/chronic large vessel occlusion in the symptomatic territory.
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11. Patient has known, untreatable hypersensitivity to contrast dye, iodine or any component of the treatment device that cannot be medically controlled.
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12. The intracranial occlusion is suspected to be chronic based on past imaging, clinical history, or clinical judgment.
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13. Patient has a severe or life-threatening comorbidity that could confound study results, or that will render the procedure unlikely to benefit the patient.
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14. Patient is unable to complete scheduled follow-up assessments due to comorbidities, geographical limitations, or a life expectancy of less than 3 months.
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15. Patient is enrolled in another device or drug study in which participation could confound study results.
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16. Imaging (CT or MR) exclusion criteria:
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- Presence of intracerebral hemorrhage as evidenced on initial imaging
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- Ischemic changes in the posterior circulation territories (including the vertebra-basilar and posterior cerebral arteries)
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- Significant mass effect with midline shift
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- Evidence of intracranial tumor
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- Baseline ischemic core lesion \>50 cc
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- Involvement of \> 1/3 of the middle cerebral artery territory
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- ASPECTS \<6 (hemispheric sulcal effacement and/or loss of grey-white differentiation alone are not contraindications for treatment)
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1. Inability to obtain written informed consent within 48 hours of procedure.
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2. Patient is enrolled in another device or drug study in which participation could confound study results.
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