PT  - JOURNAL ARTICLE
AU  - Justin R Mascitelli
AU  - Christopher P Kellner
AU  - Chesney S Oravec
AU  - Reade A De Leacy
AU  - Eric K Oermann
AU  - Kurt Yaeger
AU  - Srinivasan Paramasivam
AU  - Johanna T Fifi
AU  - J Mocco
TI  - Factors associated with successful revascularization using the aspiration component of ADAPT in the treatment of acute ischemic stroke
AID  - 10.1136/neurintsurg-2016-012439
DP  - 2017 Jul 01
TA  - Journal of NeuroInterventional Surgery
PG  - 636--640
VI  - 9
IP  - 7
4099  - http://jnis.bmj.com/content/9/7/636.short
4100  - http://jnis.bmj.com/content/9/7/636.full
SO  - J NeuroIntervent Surg2017 Jul 01; 9
AB  - Introduction ADAPT (a direct aspiration first pass technique) has been shown to be fast, cost-effective, and associated with excellent angiographic and clinical outcomes in the treatment of acute ischemic stroke (AIS).Objective To identify any and all preoperative factors that are associated with successful revascularization using aspiration alone.Methods A retrospective review of 76 patients with AIS treated with thrombectomy was carried out. Cohort 1 included cases in which aspiration alone was successful (Thrombolysis in Cerebral Infarction 2b or 3). Cohort 2 included cases in which aspiration was unsuccessful or could not be performed despite an attempt.Results There was no difference between cohorts in gender, race, medications, National Institute of Health Stroke Scale score, IV tissue plasminogen activator, site or side of the occlusion, dense vessel sign, aortic arch type, severe stenosis, clot length, operator years of experience, and guide/aspiration catheters used. Patients in cohort 1 were on average younger (66.5 vs 74.1 years, p=0.025). There was a trend for more patients in cohort 2 to have atrial fibrillation/arrhythmias (62.5% vs 45.5%, p=0.168) and have a cardiogenic stroke etiology (78.1% vs 56.8%, p=0.086). There was also a trend for more reverse curves (2.3 vs 1.7, p=0.107), larger vessel diameter (3.26 mm vs 2.88 mm, p=0.184), larger vessel-to-catheter ratio (2.09 vs 1.87, p=0.192), and worse clot burden score (5.38 vs 6.68, p=0.104) in cohort 2.Conclusions Aspiration success was associated with younger age. Our findings suggest that ADAPT can be used for the vast majority of patients but it may be beneficial to use a different method first in the elderly.