Article Figures & Data
Figures
- FIGURE.
Time from groin puncture to maximal revascularization after a front-line Solitaire stent retriever approach compared with ADAPT. P value for the comparison in time from groin puncture to maximal recanalization is reported (Mann-Whitney U test). Bars indicate the medians with interquartile range values, which were 50 minutes (range, 25–80 minutes) in the Solitaire group and 45 minutes (27–70 minutes) in the ADAPT group.
Tables
- Table 1:
Baseline characteristics in patients with acute ischemic stroke treated by ADAPT or a conventional stent retriever front-line approacha
Solitaire Group (n = 119) ADAPT Group (n = 124) P Value Age (yr) (mean) 65.5 ± 14.7 64.3 ± 15.7 .52 Men 55 (46.2) 61 (49.1) .64 Medical history Hypertension 56 (47.5) 72 (59.0) .073 Diabetes 7 (5.9) 21 (17.2) .007 Hypercholesterolemia 31 (26.3) 32 (26.2) .99 Current smoking 20 (18.4) 27 (22.1) .48 Antithrombotic therapy 43 (36.1) 44 (35.8) .95 NIHSS score (mean) 15.9 ± 6.1 15.9 ± 6.5 .99 ASPECTS value at admission (median) (IQR) 8 (7–10) 9 (8–10) .64 Occlusion site ICA (isolated or tandem with MCA) 32 (26.9) 38 (30.7) .52 Isolated MCA 87 (73.1) 86 (69.3) Previous use of IV thrombolysis 54 (45.4) 82 (66.1) .001 Onset-to-groin puncture time (min) (median) (IQR) 235 (181–300) 247 (206–308) .18 Note:—IQR indicates interquartile range.
↵a Values are expressed as number (percentages) unless otherwise indicated.
Outcomesa Solitaire Group (n = 119) ADAPT Group (n= 124) Relative Risk P Value Relative Riskb P Valueb Successful revascularization at final angiogram 82 (68.9) 102 (82.3) 1.19 (1.03–1.38) .015 1.18 (1.02–1.37) .022 Early neurologic improvement 61 (55.5) 56 (57.1) 1.03 (0.81–1.31) .81 1.00 (0.78–1.28) .99 90-day excellent outcome 44 (38.3) 45 (39.1) 1.02 (0.73–1.42) .89 1.10 (0.78–1.56) .58 90-day favorable outcome 63 (54.8) 61 (53.0) 0.97 (0.76–1.23) .79 1.05 (0.82–1.35) .70 90-day mortality 20 (17.4) 26 (22.6) 1.30 (0.77–2.19) .32 1.14 (0.64–2.01) .65 ENT 8 (6.8) 7 (5.7) – .70 – – sICH 7 (5.9) 3 (2.4) – .21 – – Note:—ENT indicates embolization in a new territory rate; sICH, symptomatic intracranial hemorrhage.
↵a Early neurologic improvement is defined as an NIHSS score 0–1 at 24 hours or a decrease of ≥4 points in NIHSS scores at 24 hours. Excellent outcome is defined as an mRS score of ≤1; favorable outcome, an mRS score of ≤2; and successful recanalization, an mTICI score of 2b–3 at final angiography.
↵b Adjusted for between-group differences in hypertension, diabetes, prior IV thrombolysis, and onset-to-groin puncture time (calculated with a robust Poisson regression model).
Jump to section
Related Articles
Cited By...
- Predictors of distal embolization during thrombectomy for anterior circulation large vessel bifurcation occlusion stroke
- Evaluating Thrombectomy Devices and Combination Therapies in Acute ischemic Stroke: A systematic review & Network Meta-Analysis of 201 studies
- Endovascular thrombectomy first-pass reperfusion and ancillary device placement
- First-line thrombectomy strategy for anterior large vessel occlusions: results of the prospective ETIS egistry
- Impact of aspiration catheter size on first-pass effect in the combined use of contact aspiration and stent retriever technique
- Comparison of aspiration-first versus stentriever-first techniques in performing mechanical thrombectomy for large vessel occlusions
- Direct aspiration stroke thrombectomy: a comprehensive review
- Combined use of contact aspiration and the stent retriever technique versus stent retriever alone for recanalization in acute cerebral infarction: the randomized ASTER 2 study protocol
- Prediction of Hemorrhage after Successful Recanalization in Patients with Acute Ischemic Stroke: Improved Risk Stratification Using Dual-Energy CT Parenchymal Iodine Concentration Ratio Relative to the Superior Sagittal Sinus
- Need for rescue treatment and its implication: stent retriever versus contact aspiration thrombectomy
- Firstline a direct aspiration first pass technique versus firstline stent retriever for acute basilar artery occlusion: a systematic review and meta-analysis
- ADAPT technique with ACE68 and ACE64 reperfusion catheters in ischemic stroke treatment: results from the PROMISE study
- Larger ACE 68 aspiration catheter increases first-pass efficacy of ADAPT technique
- Anterior cerebral artery embolism during thrombectomy increases disability and mortality
- Outcomes of Stent Retriever versus Aspiration-First Thrombectomy in Ischemic Stroke: A Systematic Review and Meta-Analysis
- Comparison of the efficacy and safety of thrombectomy devices in acute stroke : a network meta-analysis of randomized trials
- Thrombectomy for M1-Middle Cerebral Artery Occlusion: Angiographic Aspect of the Arterial Occlusion and Recanalization: A Preliminary Observation
- Iodine Extravasation Quantification on Dual-Energy CT of the Brain Performed after Mechanical Thrombectomy for Acute Ischemic Stroke Can Predict Hemorrhagic Complications
- Neuroendovascular management of emergent large vessel occlusion: update on the technical aspects and standards of practice by the Standards and Guidelines Committee of the Society of NeuroInterventional Surgery
- Endovascular Thrombectomy in Acute Ischemic Stroke
- The Use and Utility of Aspiration Thrombectomy in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis
- Predictors of the Aspiration Component Success of a Direct Aspiration First Pass Technique (ADAPT) for the Endovascular Treatment of Stroke Reperfusion Strategy in Anterior Circulation Acute Stroke
- Successful Reperfusion With Mechanical Thrombectomy Is Associated With Reduced Disability and Mortality in Patients With Pretreatment Diffusion-Weighted Imaging-Alberta Stroke Program Early Computed Tomography Score <=6