Journal ArticleDOI
Initial clinical experience with the ADAPT technique: a direct aspiration first pass technique for stroke thrombectomy
Aquilla S Turk,Alex Spiotta,Don Frei,J Mocco,Blaise Baxter,David Fiorella,Adnan H. Siddiqui,Maxim Mokin,Michael C. Dewan,Henry H. Woo,Raymond D Turner,Harris Hawk,Amrendra Miranpuri,Imran Chaudry +13 more
TLDR
The ADAPT technique is a simple and effective approach to acute ischemic stroke thrombectomy and Utilizing the latest generation of large bore aspiration catheters in this fashion has allowed us to achieve excellent clinical and angiographic outcomes.Abstract:
Background The development of new revascularization devices has improved recanalization rates and time but not clinical outcomes. We report our initial results with a new technique utilizing a direct aspiration first pass technique with a large bore aspiration catheter as the primary method for vessel recanalization. Methods A retrospective evaluation of a prospectively captured database of 37 patients at six institutions was performed on patients where the ADAPT technique was utilized. The data represent the initial experience with this technique. Results The ADAPT technique alone was successful in 28 of 37 (75%) cases although six cases had large downstream emboli that required additional aspiration. Nine cases required the additional use of a stent retriever and one case required the addition of a Penumbra aspiration separator to achieve recanalization. The average time from groin puncture to at least Thrombolysis in Cerebral Ischemia (TICI) 2b recanalization was 28.1 min, and all cases were successfully revascularized. TICI 3 recanalization was achieved 65% of the time. On average, patients presented with an admitting National Institutes of Health Stroke Scale (NIHSS) score of 16.3 and improved to an NIHSS score of 4.2 by the time of hospital discharge. There was one procedural complication. Discussion This initial experience highlights the fact that the importance of the technique with which new stroke thrombectomy devices are used may be as crucial as the device itself. The ADAPT technique is a simple and effective approach to acute ischemic stroke thrombectomy. Utilizing the latest generation of large bore aspiration catheters in this fashion has allowed us to achieve excellent clinical and angiographic outcomes.read more
Citations
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Journal ArticleDOI
Effect of Endovascular Contact Aspiration vs Stent Retriever on Revascularization in Patients With Acute Ischemic Stroke and Large Vessel Occlusion: The ASTER Randomized Clinical Trial.
Bertrand Lapergue,Raphaël Blanc,Benjamin Gory,Julien Labreuche,Alain Duhamel,Gaultier Marnat,Suzana Saleme,Vincent Costalat,Serge Bracard,Hubert Desal,Mikael Mazighi,Arturo Consoli,Michel Piotin +12 more
TL;DR: Among patients with ischemic stroke in the anterior circulation undergoing thrombectomy, first-line throm bectomy with contact aspiration compared with stent retriever did not result in an increased successful revascularization rate at the end of the procedure.
Journal ArticleDOI
ADAPT FAST study: a direct aspiration first pass technique for acute stroke thrombectomy
Aquilla S Turk,Don Frei,David Fiorella,J Mocco,Blaise Baxter,Adnan H. Siddiqui,Alex Spiotta,Maxim Mokin,Michael C. Dewan,Steve Quarfordt,Holly Battenhouse,Raymond D Turner,Imran Chaudry +12 more
TL;DR: The ADAPT technique is a fast, safe, simple, and effective method that has facilitated the approach to acute ischemic stroke thrombectomy by utilizing the latest generation of large bore aspiration catheters to achieve previously unparalleled angiographic outcomes.
Journal ArticleDOI
Aspiration thrombectomy versus stent retriever thrombectomy as first-line approach for large vessel occlusion (COMPASS): a multicentre, randomised, open label, blinded outcome, non-inferiority trial
Aquilla S Turk,Adnan H. Siddiqui,Johanna T Fifi,Reade De Leacy,David Fiorella,Eugene Gu,Elad I. Levy,Kenneth V. Snyder,Ricardo A. Hanel,Amin Aghaebrahim,B Keith Woodward,Harry R Hixson,M Chaudry,Alejandro M Spiotta,Ansaar T Rai,Donald Frei,Josser E Delgado Almandoz,Michael Kelly,Adam S Arthur,Blaise Baxter,Joey English,Italo Linfante,Kyle M Fargen,J Mocco +23 more
TL;DR: This study supports the use of direct aspiration as an alternative to stent retriever as first-line therapy for stroke thrombectomy and assesses whether patients treated with aspiration as first pass have non-inferior functional outcomes to those treated with a stent retrievers as first line.
Journal ArticleDOI
Aspiration Thrombectomy after Intravenous Alteplase Versus Intravenous Alteplase Alone
J Mocco,Osama O. Zaidat,Rüdiger von Kummer,Albert J Yoo,Rishi Gupta,Demetrius K. Lopes,Don Frei,Harish Shownkeen,Ron Budzik,Zahra Ajani,Aaron W. Grossman,Dorethea Altschul,Cameron M. McDougall,Lindsey Blake,Brian-Fred Fitzsimmons,Dileep R. Yavagal,John Terry,Jeffrey Farkas,Seon Kyu Lee,Blaise Baxter,Martin Wiesmann,Michael Knauth,Donald V. Heck,Syed I. Hussain,David Chiu,Michael J. Alexander,T Malisch,Jawad F. Kirmani,Laszlo Miskolczi,Pooja Khatri +29 more
TL;DR: It is possible that an alternate method of thrombectomy, primary aspiration, will benefit selected patients harboring large vessel ischemic stroke, and THERAPY did not achieve its primary end point in this underpowered sample.
Journal ArticleDOI
Risk of distal embolization with stent retriever thrombectomy and ADAPT
TL;DR: The risk of distal embolization is affected by the catheterization technique and clot mechanics, and direct aspiration significantly increased the risk of SEC fragmentation by at least twofold.
References
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Journal ArticleDOI
The Impact of Recanalization on Ischemic Stroke Outcome A Meta-Analysis
Joung-Ho Rha,Jeffrey L. Saver +1 more
TL;DR: Recanalization is strongly associated with improved functional outcomes and reduced mortality and is an appropriate biomarker of therapeutic activity in early phase trials of thrombolytic treatment in acute ischemic stroke.
Journal ArticleDOI
Solitaire flow restoration device versus the Merci Retriever in patients with acute ischaemic stroke (SWIFT): a randomised, parallel-group, non-inferiority trial
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Journal ArticleDOI
Trevo versus Merci retrievers for thrombectomy revascularisation of large vessel occlusions in acute ischaemic stroke (TREVO 2): a randomised trial
Raul G. Nogueira,Helmi L. Lutsep,Rishi Gupta,Tudor G Jovin,Gregory W. Albers,Gary Walker,David S Liebeskind,Wade S. Smith +7 more
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Journal ArticleDOI
Conscious Sedation Versus General Anesthesia During Endovascular Therapy for Acute Anterior Circulation Stroke Preliminary Results From a Retrospective, Multicenter Study
Alex Abou-Chebl,Ridwan Lin,Muhammad S Hussain,Tudor G Jovin,Elad I. Levy,David S Liebeskind,Albert J Yoo,Daniel P Hsu,Marilyn M. Rymer,Ashis H Tayal,Osama O. Zaidat,Sabareesh K. Natarajan,Raul G. Nogueira,Ashish Nanda,Melissa Tian,Qing Hao,Junaid S. Kalia,Thanh N. Nguyen,Michael Chen,Rishi Gupta,Rishi Gupta +20 more
TL;DR: Patients placed under GA during IAT for anterior circulation stroke appear to have a higher chance of poor neurologic outcome and mortality and future clinical trials with IAT can help elucidate the etiology of the differences in outcomes.
Journal ArticleDOI
Comparison of Safety and Clinical and Radiographic Outcomes in Endovascular Acute Stroke Therapy for Proximal Middle Cerebral Artery Occlusion With Intubation and General Anesthesia Versus the Nonintubated State
Mouhammad A. Jumaa,Fan Zhang,Gerardo Ruiz-Ares,Theresa A. Gelzinis,Amer M. Malik,Aitziber Aleu,Jennifer I. Oakley,Brian Jankowitz,Ridwan Lin,Vivek Y. Reddy,Syed Zaidi,Maxim D. Hammer,Lawrence R. Wechsler,Michael B. Horowitz,Tudor G. Jovin +14 more
TL;DR: In endovascular acute stroke therapy, treatment of patients in NIS appears to be as safe as treatment in IS and may result in more favorable clinical and radiographic outcomes.
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