A Direct Aspiration, First Pass Technique (ADAPT) versus Stent Retrievers for Acute Stroke Therapy: An Observational...

Area of Science:

• Neurology
• Interventional Neuroradiology
• Cardiovascular Diseases

Background:

• Mechanical thrombectomy using stent retrievers is standard for ischemic stroke.
• A Direct Aspiration, First Pass Technique (ADAPT) shows promise for high recanalization rates.

Purpose of the Study:

• Compare the efficacy and safety of ADAPT versus stent retrievers (Solitaire device).
• Evaluate front-line endovascular treatment for ischemic stroke.

Main Methods:

• Analyzed 243 patients with anterior circulation large intracranial artery occlusions.
• Patients underwent mechanical thrombectomy within 6 hours using ADAPT or Solitaire stent.
• Primary outcome: complete recanalization (modified TICI ≥ 2b); secondary outcomes: complication and clinical outcomes.

Main Results:

• ADAPT group (124 patients) showed higher recanalization rates (82.3%) than Solitaire group (119 patients, 68.9%).
• No significant difference in time to recanalization or clinical outcomes.
• Higher use of adjunctive devices in ADAPT group; no significant difference in embolization or hemorrhage rates.

Conclusions:

• Front-line ADAPT demonstrated superior recanalization rates compared to the Solitaire stent retriever.
• Further randomized controlled trials are necessary to establish optimal mechanical thrombectomy strategies.