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

Area of Science:

• Neurology
• Interventional Neuroradiology
• Vascular Surgery

Background:

• Despite advancements in revascularization devices, clinical outcomes in acute ischemic stroke have not significantly improved.
• The Direct Aspiration First Pass Technique (ADAPT) using large bore aspiration catheters is a novel approach for vessel recanalization.

Purpose of the Study:

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

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 revascularization rates to 95%.
• The average time to recanalization was 37 minutes, with significant improvement in National Institutes of Health Stroke Scale (NIHSS) scores from admission to discharge (17.0 to 7.3).

Conclusions:

• The ADAPT technique is a fast, safe, simple, and effective method for acute ischemic stroke thrombectomy.
• This technique, utilizing large bore aspiration catheters, achieves high angiographic outcomes, improving the approach to stroke intervention.