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Necessary Catheter Diameters for Mechanical Thrombectomy with ADAPT
O Nikoubashman1, A Nikoubashman2, M Büsen3
1From the Department of Diagnostic and Interventional Neuroradiology (O.N., M.W.), University Hospital, RWTH Aachen University, Aachen, Germany onikoubashman@ukaachen.de.
AJNR. American Journal of Neuroradiology
|October 14, 2017
Summary
A new theoretical model accurately predicts the minimum catheter diameter required for effective direct aspiration first-pass technique (ADAPT) in mechanical thrombectomy for ischemic stroke, aiding device selection.
Area of Science:
- Endovascular therapy
- Neurology
- Medical device engineering
Background:
- Mechanical thrombectomy is a key treatment for ischemic stroke.
- The direct aspiration first-pass technique (ADAPT) utilizes large-bore catheters for clot retrieval.
- Optimal catheter selection is crucial for ADAPT success.
Purpose of the Study:
- To develop a theoretical model for determining the minimal catheter diameters necessary for ADAPT.
- To validate this model using an in vivo porcine model of mechanical thrombectomy.
Main Methods:
- A theoretical model was established to calculate minimal catheter diameters for ADAPT.
- Model validation involved 28 ADAPT procedures in a porcine model.
- The model accounted for variations including microcatheter/microwire use and aspiration methods (syringe vs. pump).
Main Results:
- Calculations indicated required inner diameters of >0.040 inch (MCA) and >0.064 inch (ICA).
- A significant correlation (P=.010) was found between predicted and actual thrombectomy outcomes.
- The model demonstrated a positive predictive value of 78% and negative predictive value of 79%.
Conclusions:
- The developed theoretical model accurately estimates minimal catheter diameters for successful ADAPT.
- The model showed good agreement with experimental results from animal studies.
- This tool can assist interventionalists in selecting appropriately sized catheters, improving ADAPT efficacy.
