Introduction: Development of new revascularization devices has led to faster recanalization and better outcomes. The ADAPT technique has been introduced as a simple, fast method for achieving good angiographic and clinical outcomes using large bore aspiration catheters. We present a single center’s long-term experience with the technique.
Methods: Retrospective analysis from a prospectively maintained database was gathered on patients undergoing stroke thrombectomy with the ADAPT technique at the Medical University of South Carolina. Speci?c parameters captured included age, gender, NIHSS score at presentation, time to presentation from last normal, and modi?ed Rankin Scale score at 90-days. Radiological and angiographic imaging was reviewed to document location of vascular occlusion, TICI ?ow post procedure, and procedural complications.
Results: 175 consecutive patients treated with the ADAPT technique for acute ischemic stroke were reviewed. 88 were female. The average age was 66.8 years. Patients presented with a mean NIHSS score of 15.6, and 69 patients received IV tPA. The average time from onset to puncture was 7.75 hours. The average time for recanalization was 40 minutes. TICI 2B or better was achieved in 166 (94.9%) patients. 90-day mRS averaged 2.7. 82 (50.31%) patients had an mRS of 0-2 at 90 days.
Direct aspiration alone was performed in 130 cases. 45 required additional use of a stent retriever. There was no significant difference in presenting NIHSS, average time to presentation, average mRS at 90 days, or 90-day mortality between groups. Time to recanalization was 33.8 minutes for direct aspiration, and 58 minutes in cases requiring adjunct devices (p= 0.000036). 67 (63.21%) patients who underwent direct aspiration only achieved a good outcome at 90 days (mRS 0-2), compared to 15 (44.12%) who underwent adjunct therapies (p-value=0.021).
Conclusions: The ADAPT technique is an effective method to achieve good clinical and angiographic outcomes and serves as a useful first-line method for revascularization.
Patient Care: This study demonstrates the safety and efficacy of the ADAPT technique in the management of acute ischemic stroke.
Learning Objectives: The audience should be able to understand the role of the ADAPT technique in the treatment of acute ischemic stroke in a timely manner.