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Larger ACE 68 aspiration catheter increases first-pass efficacy of ADAPT technique
- Source :
- Journal of NeuroInterventional Surgery. 11:141-146
- Publication Year :
- 2018
- Publisher :
- BMJ, 2018.
-
Abstract
- PurposeTo report the efficacy of A Direct Aspiration first-Pass Thrombectomy (ADAPT) technique with larger-bore ACE aspiration catheters as first-line treatment for anterior circulation emergent large vessel occlusions (ELVOs), and assess for the presence of a first-pass effect with ADAPT.MethodsWe retrospectively reviewed 152 consecutive patients with anterior circulation ELVOs treated with the ADAPT technique as first-line treatment using ACE60, 64, or 68 at our institution. Baseline characteristics, procedural variables, and modified Rankin Scale (mRS) at 90 days were recorded.ResultsFifty-seven patients were treated with ACE60 (37.5%), 35 with ACE64 (23%), and 60 with ACE68 (39.5%). Median groin puncture to reperfusion time was 30 min with ACE60, 26 min with ACE64, and 19.5 min with ACE68. Successful reperfusion after the first ADAPT pass was 33% with ACE60 and 53% with ACE68 (P=0.04). The stent-retriever rescue rate was 26% with ACE60, 3% with ACE64, and 10% with ACE68 (P=0.004). In multivariate logistic regression analysis, use of the ACE68 aspiration catheter was an independent predictor of successful reperfusion after the first ADAPT pass (P=0.016, OR1.67, 95% CI 1.1 to 2.54), and successful reperfusion after the first ADAPT pass was an independent predictor of good clinical outcome at 90 days (P=0.0004, OR6.2, 95% CI 2.27 to 16.8).ConclusionUse of the larger-bore ACE 68 aspiration catheter was associated with shorter groin puncture to reperfusion time, higher rate of successful reperfusion after the first ADAPT pass, and lower rate of stent-retriever rescue. Further, a first-pass effect was demonstrated in our ADAPT patient cohort.
- Subjects :
- Adult
Male
Catheters
Brain Ischemia
030218 nuclear medicine & medical imaging
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Modified Rankin Scale
medicine
Humans
Stroke
Aged
Retrospective Studies
Thrombectomy
First pass
Aspiration catheter
Groin
business.industry
General Medicine
Middle Aged
medicine.disease
Cerebrovascular Disorders
Catheter
Treatment Outcome
medicine.anatomical_structure
Baseline characteristics
Anesthesia
Reperfusion
Cohort
Female
Surgery
Neurology (clinical)
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 17598486 and 17598478
- Volume :
- 11
- Database :
- OpenAIRE
- Journal :
- Journal of NeuroInterventional Surgery
- Accession number :
- edsair.doi.dedup.....4b6b292f4bd7d8707feb305fea146810