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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Patent
Anchoring delivery system and methods
TL;DR: In this article, an anchoring delivery system for use in an intracranial artery is provided including a tethering device (100) having an elongated tether (104) and an anchor coupled to a distal end of the tether.
Journal ArticleDOI
Efficacy of Proximal Aspiration Thrombectomy for Using Balloon-Tipped Guide Catheter in Acute Intracranial Internal Carotid Artery Occlusion
TL;DR: A strategy of PAT before standard MT may result in shorter puncture-to-reperfusion time and better angiographic outcome than a strategy of standard MT for acute intracranial ICA occlusion.
Journal ArticleDOI
ASPECTS discrepancies between CT and MR imaging: analysis and implications for triage protocols in acute ischemic stroke
Ferdinand K. Hui,Nancy A. Obuchowski,Seby John,Gábor Tóth,Irene L. Katzan,Dolora Wisco,Esteban Cheng-Ching,Ken Uchino,Shumei Man,Shazam Hussain +9 more
TL;DR: This study suggests that patients with NIHSS scores at admission of <16 and patients with CT ASPECTS >7 have a higher likelihood of agreement between CT and DWI based on an ASPECts cut-off value of 6.
Journal ArticleDOI
Dump the pump: manual aspiration thrombectomy (MAT) with a syringe is technically effective, expeditious, and cost-efficient
TL;DR: In this clinical series, 106/113 acute stroke thrombectomies over a 6-month period were performed with syringe MAT on the first pass, and syringe usage instead of pump tubing and a canister led to a total savings of $58 300.
Journal ArticleDOI
A direct aspiration first-pass technique (ADAPT) versus stent retriever for acute ischemic stroke (AIS): a systematic review and meta-analysis
TL;DR: The pooled results indicated that patients in the ADAPT group needed more additional therapy than those in the stent retriever group (OR 2.24, 95% CI 1.41–3.57), and more large-scale randomized controlled trials are required to further investigate this topic.
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.
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Solitaire flow restoration device versus the Merci Retriever in patients with acute ischaemic stroke (SWIFT): a randomised, parallel-group, non-inferiority trial
Jeffrey L. Saver,Reza Jahan,Elad I. Levy,Tudor G Jovin,Blaise Baxter,Raul G Nogueira,Wayne M. Clark,Ronald F. Budzik,Osama O. Zaidat +8 more
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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
TL;DR: Patients who have had large vessel occlusion strokes but are ineligible for (or refractory to) intravenous tissue plasminogen activator should be treated with the Trevo Retriever in preference to the Merci retriever.
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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