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  • ADAPT technique for revascularization in large vessel occlusion: Single center series of 16 consecutive patients

    Final Number:
    276

    Authors:
    Michael J. Alexander MD FACS; Shlee Song; Wengui Yu MD

    Study Design:
    Clinical trial

    Subject Category:
    Ischemic Stroke

    Meeting: AANS/CNS Cerebrovascular Section 2015 Annual Meeting

    Introduction: The ADAPT technique utilizes a large aspiration catheter for clot extraction in large vessel occlusion in acute ischemic stroke.

    Methods: This was a prospective study utilizing the ADAPT technique for mechanical thrombectomy in patients with occlusion of the intracranial internal carotid artery, middle cerebral artery, vertebral artery, or basilar artery within 8 hours of onset of symptoms. The ACE catheter was used in 15 cases, and the 4 MAX catheter in one case. In three cases, the use of an adjuctive stent retriever was necessary for clot retrieval. All patients had pre and post NIHSS assessments and delayed mRS grading. Post-procedure imaging was performed at 24 hours in all patients.

    Results: The ADAPT technique alone resulted in successful revascularization in 81% of the patients. Additional use of a stent retriever was used in the remaining patients. The average number of passes for the ADAPT technique was 1.5 with an average revascularization time of 17 minutes from groin puncture. A TICI 2b or 3 was achieved in 93.8% of patients using ADAPT and secondary stent retriever. On clinical follow up, 68% of patients had mRS 2 or less, with 25% of patients with an mRS of 0. There were two patients who died. The mean NIHSS prior to revascularization was 17, and following the procedure, the mean NIHSS was 5.

    Conclusions: The ADAPT technique as a first line endovascular therapy for acute large vessel stroke results in rapid revascularization, high percentage full revascularization, and markedly improved clinical outcomes, compared to either the IV tPA alone group or Interventional cohort in IMS3.

    Patient Care: Physicians will continue to learn of the efficacy of this technique in treating acute stroke.

    Learning Objectives: 1. Understand the basic technique of the ADAPT procedure 2. Learn of the potential benefits of this technique vs. other mechanical thrombectomy techniques 3. Understand the limitations of the ADAPT technique

    References:

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