ADAPT FAST study: a direct aspiration first pass technique for acute stroke thrombectomy

Area of Science:

• Endovascular Therapy
• Neurointerventional Surgery
• Cerebrovascular Diseases

Background:

• Despite advancements in revascularization devices, clinical outcomes in acute ischemic stroke have not significantly improved.
• A novel technique using a direct aspiration first pass technique (ADAPT) with large bore aspiration catheters was evaluated for vessel recanalization.

Purpose of the Study:

• To assess the safety and efficacy of the ADAPT technique as a primary method for large cerebral vessel recanalization in acute ischemic stroke.
• To evaluate the impact of ADAPT on recanalization rates, procedural times, and clinical outcomes.

Main Methods:

• A prospective study included 98 acute ischemic stroke patients with 100 occluded large cerebral vessels across six institutions.
• The ADAPT technique was employed in all cases, with procedural and clinical data meticulously collected for analysis.

Main Results:

• ADAPT alone achieved Thrombolysis in Cerebral Infarction (TICI) 2b or 3 revascularization in 78% of cases.
• The addition of stent retrievers increased TICI 2b/3 rates to 95%, with an average recanalization time of 37 minutes.
• Patients showed significant improvement in National Institutes of Health Stroke Scale (NIHSS) scores, with 40% achieving modified Rankin Scale (mRS) 0-2 at 90 days. No symptomatic intracerebral hemorrhages occurred.

Conclusions:

• The ADAPT technique is a rapid, safe, and effective approach for acute ischemic stroke thrombectomy.
• The use of large bore aspiration catheters with ADAPT leads to superior angiographic outcomes.
• This technique simplifies the thrombectomy process and improves patient functional status.