Imperative Care Showcases Strong Real-World Results for ADAPT 2.0 Procedures Performed with the Zoom Stroke System
Imperative Care, Inc. announced the presentation of important late-breaking real-world clinical data demonstrating the performance of ADAPT 2.0 a next-generation evolution of the A Direct Aspiration First Pass Technique (ADAPT)—for the treatment of ischemic stroke. The findings, drawn from a multi-center review of patient outcomes, were presented at the 2025 Society of Vascular and Interventional Neurology (SVIN) Annual Meeting in Orlando, Florida. The company emphasized that ADAPT 2.0 represents a significant advancement in aspiration-based mechanical thrombectomy, supported by new clinical evidence showing both procedural efficiency and high rates of successful clot removal.
ADAPT 2.0 integrates several innovations designed to enhance the original ADAPT technique, which was first introduced and clinically validated in 2014. That earlier generation of ADAPT helped reshape the landscape of stroke care by demonstrating that direct aspiration could be used effectively as a frontline strategy for clot retrieval. The technique provided physicians with a fast, efficient, and intuitive workflow, ultimately reinforcing the importance of aspiration in mechanical thrombectomy and influencing device design and procedural approaches in subsequent years.
Building on that foundation, ADAPT 2.0 incorporates new capabilities intended to further streamline procedures while improving control during clot extraction. This modernized approach combines three key elements: 0.088” intracranial access, asymmetric aspiration, and the continuous dual aspiration technique (CDAT). Together, these components were engineered to help physicians achieve faster and more consistent reperfusion while minimizing the risk of losing thrombus during the procedure. According to Imperative Care, the Zoom Stroke System is currently the only mechanical thrombectomy platform specifically designed to fully support and execute the ADAPT 2.0 workflow.
The 0.088” intracranial access catheter, which lies at the center of the ADAPT 2.0 approach, enables operators to navigate closer to the occlusion site, allowing aspiration to be applied more directly and effectively. Asymmetric aspiration is used to enhance clot ingestion by generating flow dynamics that help guide the thrombus into the aspiration catheter. Meanwhile, continuous dual aspiration—applied simultaneously through inner and outer catheters—helps maintain steady aspiration forces and reduces the likelihood of clot loss during removal. Imperative Care noted that when these elements are combined into a unified procedural strategy, physicians may achieve a higher degree of control, predictability, and consistency in stroke thrombectomy cases.
The newly presented real-world data included outcomes from 124 consecutive ischemic stroke patients treated with ADAPT 2.0 using the Zoom Stroke System across multiple clinical sites between April and September 2025. These data were presented by Max Mokin, M.D., Ph.D., of the University of South Florida, who served as one of the investigators participating in the review. According to the dataset, the majority of treated occlusions were located in the M1 segment of the middle cerebral artery (48%, 59 out of 124), followed by occlusions in the M2 segment (24%, 30 out of 124). These segments represent some of the most common and clinically impactful locations for large vessel occlusions in ischemic stroke.
Across the full patient cohort, the analysis showed strong angiographic and procedural outcomes. A 97% rate of final modified Thrombolysis in Cerebral Infarction (mTICI) ≥2b was observed, indicating a high frequency of successful reperfusion. Additionally, 80% of patients achieved final mTICI ≥2c, demonstrating near-complete or complete reperfusion in a substantial proportion of cases. The median procedure time was reported at only 17 minutes, and the majority of procedures required just a single pass, underscoring the efficiency of the ADAPT 2.0 methodology when used with the Zoom Stroke System.
Among the 113 cases where complete clot ingestion data were documented, 98% resulted in full clot capture in one or both Zoom PODs. Notably, outer Zoom 88 POD clot capture occurred in 35% of the cases. Investigators highlighted that without the use of continuous dual aspiration, particularly through the outer catheter, these clots may have been at greater risk of fragmenting or being lost. The presence of clot within the Zoom 88 POD provided important confirmation of the functional role played by the CDAT technique.
Commenting on the findings, Emir Deljkich, Senior Vice President of Clinical Affairs at Imperative Care, expressed enthusiasm about the significance of the results. “We are thrilled to see the procedural benefits of ADAPT 2.0—a potential next frontier in stroke care—represented so clearly in the results of this study,” he said. Deljkich emphasized that the combined power of 0.088” intracranial access, asymmetric aspiration, and CDAT allows physicians to streamline procedures by relying on fewer devices while also gaining greater control over the clot. He noted that the 17-minute median procedure time reflected in these real-world results aligns with growing evidence showing that faster puncture-to-reperfusion times can meaningfully improve patient outcomes. Recent clinical studies have reinforced the relationship between rapid reperfusion and higher rates of functional independence, underscoring the importance of procedural efficiency.
Deljkich added that the company is committed to advancing clinical evidence for ADAPT 2.0 through future prospective research. “We look forward to gathering additional prospective evidence to further validate the clinical performance of ADAPT 2.0 in stroke thrombectomy,” he said, highlighting Imperative Care’s broader goal of supporting physicians with data-driven innovation.
Dr. Mokin, who presented the data at the SVIN meeting, echoed these observations. He emphasized that the combination of a short median procedure time, minimal device passes, and high rates of full clot ingestion points to meaningful procedural advantages associated with ADAPT 2.0. “In addition to the 17-minute median procedure time and the minimal number of passes per procedure, we saw a 98% rate of full clot ingestion in this cohort, meaning the entire clot was successfully captured in one or both Zoom PODs,” he noted.
He further explained that the occurrence of clot within the Zoom 88 POD in 35% of cases highlights the value of continuous dual aspiration applied through both the inner and outer catheters. Without CDAT, portions of the clot might have been lost during retrieval, reducing the likelihood of achieving complete reperfusion in a single pass. According to Mokin, this finding underscores a potential key advantage of ADAPT 2.0—namely, that it gives physicians improved visual and procedural feedback as well as greater confidence in clot capture throughout the intervention.
“This underscores a key potential benefit of ADAPT 2.0, providing physicians with greater control and confidence during stroke procedures by reducing the risk of clot loss and offering immediate visual feedback of clot capture,” he said. Mokin expressed optimism about the future of the approach, noting that larger studies may help further elucidate and quantify the clinical benefits of CDAT and the broader ADAPT 2.0 technique for ischemic stroke patients.
Overall, the real-world results presented at SVIN 2025 reflect an encouraging step forward in the evolution of aspiration-based mechanical thrombectomy. Through innovations such as ADAPT 2.0 and the Zoom Stroke System, Imperative Care aims to support physicians in delivering faster, more predictable, and more effective treatment for patients experiencing acute ischemic stroke.
