Aquilla S Turk1, Don Frei2, David Fiorella3, J Mocco4, Blaise Baxter5, Adnan Siddiqui6, Alex Spiotta7, Maxim Mokin3, Michael Dewan8, Steve Quarfordt5, Holly Battenhouse9, Raymond Turner7, Imran Chaudry1. 1. Department of Radiology, Medical University of South Carolina, Charleston, South Carolina, USA. 2. Department of Interventional Neuroradiology, Radiology Imaging Associates, Englewood, Colorado, USA. 3. Department of Neurological Surgery, Stony Brook Medicine, Stony Brook, New York, USA. 4. Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee, USA. 5. Tennessee Interventional Associates, Chattanooga, Tennessee, USA. 6. Department of Neurosurgery, University of Buffalo, Buffalo, New York, USA. 7. Division of Neurosciences, Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA. 8. Department of Neurological Surgery, Vanderbilt University, Nashville, Tennessee, USA. 9. Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA.
Abstract
BACKGROUND: The development of new revascularization devices has improved recanalization rates and time, but not clinical outcomes. We report a prospectively collected clinical experience with a new technique utilizing a direct aspiration first pass technique with large bore aspiration catheter as the primary method for vessel recanalization. METHODS: 98 prospectively identified acute ischemic stroke patients with 100 occluded large cerebral vessels at six institutions were included in the study. The ADAPT technique was utilized in all patients. Procedural and clinical data were captured for analysis. RESULTS: The aspiration component of the ADAPT technique alone was successful in achieving Thrombolysis in Cerebral Infarction (TICI) 2b or 3 revascularization in 78% of cases. The additional use of stent retrievers improved the TICI 2b/3 revascularization rate to 95%. The average time from groin puncture to at least TICI 2b recanalization was 37 min. A 5MAX demonstrated similar success to a 5MAX ACE in achieving TICI 2b/3 revascularization alone (75% vs 82%, p=0.43). Patients presented with an admitting median National Institutes of Health Stroke Scale (NIHSS) score of 17.0 (12.0-21.0) and improved to a median NIHSS score at discharge of 7.3 (1.0-11.0). Ninety day functional outcomes were 40% (modified Rankin Scale (mRS) 0-2) and 20% (mRS 6). There were two procedural complications and no symptomatic intracerebral hemorrhages. DISCUSSION: The ADAPT technique is a fast, safe, simple, and effective method that has facilitated our approach to acute ischemic stroke thrombectomy by utilizing the latest generation of large bore aspiration catheters to achieve previously unparalleled angiographic outcomes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
BACKGROUND: The development of new revascularization devices has improved recanalization rates and time, but not clinical outcomes. We report a prospectively collected clinical experience with a new technique utilizing a direct aspiration first pass technique with large bore aspiration catheter as the primary method for vessel recanalization. METHODS: 98 prospectively identified acute ischemic strokepatients with 100 occluded large cerebral vessels at six institutions were included in the study. The ADAPT technique was utilized in all patients. Procedural and clinical data were captured for analysis. RESULTS: The aspiration component of the ADAPT technique alone was successful in achieving Thrombolysis in Cerebral Infarction (TICI) 2b or 3 revascularization in 78% of cases. The additional use of stent retrievers improved the TICI 2b/3 revascularization rate to 95%. The average time from groin puncture to at least TICI 2b recanalization was 37 min. A 5MAX demonstrated similar success to a 5MAX ACE in achieving TICI 2b/3 revascularization alone (75% vs 82%, p=0.43). Patients presented with an admitting median National Institutes of Health Stroke Scale (NIHSS) score of 17.0 (12.0-21.0) and improved to a median NIHSS score at discharge of 7.3 (1.0-11.0). Ninety day functional outcomes were 40% (modified Rankin Scale (mRS) 0-2) and 20% (mRS 6). There were two procedural complications and no symptomatic intracerebral hemorrhages. DISCUSSION: The ADAPT technique is a fast, safe, simple, and effective method that has facilitated our approach to acute ischemic stroke thrombectomy by utilizing the latest generation of large bore aspiration catheters to achieve previously unparalleled angiographic outcomes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Authors: Roisin M O'Cearbhaill; J Alderson; S Power; D B Herlihy; P Brennan; A O'Hare; J Thornton Journal: Interv Neuroradiol Date: 2021-06-14 Impact factor: 1.764
Authors: Ahmad Sweid; Batoul Hammoud; Sunidhi Ramesh; Daniella Wong; Tyler D Alexander; Joshua Harrison Weinberg; Maureen Deprince; Jaime Dougherty; Dimitri Jean-Mickael Maamari; Stavropoula Tjoumakaris; Hekmat Zarzour; Michael R Gooch; Nabeel Herial; Victor Romo; David M Hasan; Robert H Rosenwasser; Pascal Jabbour Journal: Stroke Vasc Neurol Date: 2019-11-28
Authors: Manina M Etter; Markus Möhlenbruch; Charlotte S Weyland; Carlos Pérez-García; Manuel Moreu; Francesco Capasso; Nicola Limbucci; Omid Nikoubashman; Martin Wiesmann; Kristine Blackham; Ioannis Tsogkas; Peter Sporns; Johanna Maria Ospel; Alex Brehm; Marios-Nikos Psychogios Journal: Front Neurol Date: 2021-07-16 Impact factor: 4.003