Efficacy of SWIM technology combined with direct aspiration first pass technique for large vessel occlusion in acute...

To evaluate the safety and efficacy of Solitaire Flow Restoration stent retriever with intracranial support catheter for mechanical thrombectomy (SWIM) combined with direct aspiration first pass technique (ADAPT) for acute large vessel occlusive stroke (AIS-LVO).

A retrospective analysis was conducted on AIS-LVO patients admitted to the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from April 2021 to April 2022. The patients were divided into an observation group (n=68), who received ADAPT combined with SWIM, and a control group (n=67), who received SWIM only. The time from puncture to recanalization, postoperative vascular recanalization rate, National Institutes of Health Stroke Scale (NIHSS) and Barthel Index scores, and good prognosis rate at 90 days after surgery were compared between the two groups.

There was no significant difference in the reperfusion rate or time from puncture to reperfusion between the two groups (P > 0.05). The observation group had a significantly higher rate of excellent and good prognosis at 90 days post-surgery compared to the control group (58.82% vs. 32.84%; χ²=6.672, P=0.010). Significant differences were found between the two groups in NIHSS scores (6.58±1.47 vs. 5.63±1.0; t=2.874, P=0.010) and Barthel Index scores (72.35±8.77 vs. 76.43±7.83; t=3.120, P < 0.001). Surgical approach, ≥ 2 thrombectomy passes, and puncture-to-recanalization time ≥ 60 min were identified as predictive factors for prognosis.

ADAPT combined with SWIM is safe and effective for AIS-LVO and may improve clinical prognosis.