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O-002 Initial Clinical Experience with the ADAPT technique: A Direct Aspiration first Pass Technique for Stroke Thrombectomy
  1. A Turk1,
  2. A Spiotta2,
  3. D Frei3,
  4. J Mocco4,
  5. B Baxter5,
  6. A Siddiqui6,
  7. M Mokin6,
  8. M Dewan4,
  9. R Turner2,
  10. H Hawk1,
  11. B Miranpuri2,
  12. I Chaudry1
  1. 1Radiology, MUSC, Charleston, SC
  2. 2Department of Neurosurgery, MUSC, Charleston, SC
  3. 3Radiology, Swedish Medical Center, Englewood, CO
  4. 4Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN
  5. 5Erlanger Hospital, Tennessee Interventional Associates, Chattanooga, TN
  6. 6Department of Neurosurgery, University at Buffalo, Buffalo, NY

Abstract

Background The development of new revascularisation devices has improved recanalisation rates and time, but not clinical outcomes. We report our initial results with a new technique utilising a direct aspiration first pass technique with large bore aspiration catheter as the primary method for vessel recanalisation.

Methods A retrospective chart review of 18 patients at 5 institutions was performed on patients where the ADAPT technique was utilised. The data represents the initial experience with this technique.

Results The ADAPT technique alone was successful in 2/3 cases, although 4 cases had large downstream emboli that required additional aspiration. Four cases required the additional use of a stent retriever and one case required the addition of a Penumbra aspiration separator to achieve recanalisation. The average time from groin puncture to at least TICI 2b recanalisation was 30 minutes and all cases were successfully revascularised. TICI 3 recanalisation was achieved 72% of the time. On average, patients presented with an admitting NIHSS of 16.4 and improved to NIHSS of 3.1 by the time of discharge. There were no procedural complications.

Discussion This initial experience highlights the importance of the technique with which new stroke thrombectomy devices are used may be as crucial as the device itself. The ADAPT technique is a simple cost effective method that is leading us to re-think our approach to acute ischaemic stroke thrombectomy by simply utilising the latest generation of large bore aspiration catheters independently to achieve excellent angiographic and clinical outcomes.

Disclosures A. Turk: 1; C; Penumbra, Covidien, Microvention. A. Spiotta: None. D. Frei: None. J. Mocco: None. B. Baxter: None. A. Siddiqui: None. M. Mokin: None. M. Dewan: None. R. Turner: None. H. Hawk: None. B. Miranpuri: None. I. Chaudry: 1; C; Penumbra, Covidien, Microvention.

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