Comparation of a direct aspiration first-pass technique (ADAPT) with stent retrievers (SR) for acute stroke therapy

doi:10.3877/cma.j.issn.2095-5782.2020.01.006

Abstract

Abstract:

Objective

To compare ADAPT with stent retrievers for efficacy and safety asa front-line endovascular procedure for the treatment of acute ischemic stroke with large intracranial artery occlusion of the anterior circulation.

Methods

The clinical data of 33 patients with large intracranial artery occlusions of the anterior circulation who were treated with mechanical thrombectomy by either ADAPT (16 cases) or the stent(17 cases) in our Hospital form June 2018 to October 2019 were retrospectively analyzed. The primary outcome was complete recanalization (modified TICI 2b to 3); secondary outcomes included recanalization time (time from femoral artery puncture to recanalization), clinical outcomes and complication rates (Long-term favorable prognosis rate (mRS score of 0-2 points after 3 months), thrombus escape rate, remedial action rate, bleeding rate, mortality rate, etc.).

Results

The median baseline NIHSS score was the same for both groups (ADAPT, 13 [interquartile range, 2-23] versus stent, 11 [interquartile range, 3-19]). Recanalization rates (ADAPT, 87.5% versus stent, 70.6%], χ²=1.41, P>0.01) did not differ significantly. Time from groin puncture to recanalization, clinical outcomes and complication rates did not differ significantly between the 2 groups.

Conclusions

Compared with stent retrievers, ADAPT is effective and safe in the treatment of acute ischemic stroke. However, large sample studies are still needed to further verify the efficacy and safety of thrombus aspiration technology.

Key words: ADAPT, Stent retrievers, Efficacy, Safety, Recanalization

Feng Ao, Jianan He, Hanwei Liu, Bin Zhou. Comparation of a direct aspiration first-pass technique (ADAPT) with stent retrievers (SR) for acute stroke therapy[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2020, 08(01): 24-27.

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URL: https://zhjrfsxdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-5782.2020.01.006

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Figures/Tables 2

References 14

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	血栓抽吸组（n=16）	支架取栓组（n=17）	P值
年龄（岁）（平均值）	58.9±11.4	55.0±11.0	0.32
男性	6（37.5%）	14（82.4%）	0.01
高血压	8（50.0%）	10（58.8%）	0.44
糖尿病	4（25.0%）	2（11.8%）	0.30
抽烟史	5（31.3%）	5（29.4%）	0.60
心脏病（房颤、瓣膜病）史	10（62.5%）	2（11.8%）	0.03
术前NHISS评分（中位数）	13（2～23）	11（3～19）	0.32
发病到穿刺时间（min）	342.1±291.6	293.0±145.4	0.64

	血栓抽吸组（n=16）	支架取栓组（n=17）	P值
年龄（岁）（平均值）	58.9±11.4	55.0±11.0	0.32
男性	6（37.5%）	14（82.4%）	0.01
高血压	8（50.0%）	10（58.8%）	0.44
糖尿病	4（25.0%）	2（11.8%）	0.30
抽烟史	5（31.3%）	5（29.4%）	0.60
心脏病（房颤、瓣膜病）史	10（62.5%）	2（11.8%）	0.03
术前NHISS评分（中位数）	13（2～23）	11（3～19）	0.32
发病到穿刺时间（min）	342.1±291.6	293.0±145.4	0.64

	血栓抽吸组（n=16）	支架取栓组（n=17）	χ²/T值	P值
成功血流再通（mTICI 2b-3级）	14（87.5%）	12（70.6%）	1.41	0.23
手术时间（股动脉穿刺到血管再通，min）	62.0±29.4	64.3±25.1	0.52	0.47
术后即刻NHISS评分变化	-2.19±2.79	-1.76±2.54	0.46	0.65
术后24 h NHISS评分变化	-3.25±3.74	-2.52±4.53	0.65	0.66
90 d良好预后
（mRS 0～2分）	9（56.3%）	7（41.2%）	0.75	0.30
血栓逃逸	5（31.2%）	4（23.5%）	0.83	0.31
需补救措施	4（25.0%）	5（29.4%）	0.08	0.54
术后颅内出血	3（18.8%）	2（11.8%）	2.11	0.35
术后死亡	3（18.8%）	2（11.8%）	2.11	0.35

	血栓抽吸组（n=16）	支架取栓组（n=17）	χ²/T值	P值
成功血流再通（mTICI 2b-3级）	14（87.5%）	12（70.6%）	1.41	0.23
手术时间（股动脉穿刺到血管再通，min）	62.0±29.4	64.3±25.1	0.52	0.47
术后即刻NHISS评分变化	-2.19±2.79	-1.76±2.54	0.46	0.65
术后24 h NHISS评分变化	-3.25±3.74	-2.52±4.53	0.65	0.66
90 d良好预后
（mRS 0～2分）	9（56.3%）	7（41.2%）	0.75	0.30
血栓逃逸	5（31.2%）	4（23.5%）	0.83	0.31
需补救措施	4（25.0%）	5（29.4%）	0.08	0.54
术后颅内出血	3（18.8%）	2（11.8%）	2.11	0.35
术后死亡	3（18.8%）	2（11.8%）	2.11	0.35

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