Contact aspiration compared to stent retriever as sole intention to treat large-vessel occlusion in ischemic stroke

摘要

Background and purposeA direct aspiration first-pass technique (ADAPT) was recently evaluated in three retrospective trials as the primary method for large-vessel recanalization in acute ischemic stroke. This study sought to evaluate the clinical and angiographic outcome of ADAPT when used as the first and only method of clot retrieval compared to the accepted mechanical approach.Materials and methodsPatients with acute ischemic stroke associated with large-vessel occlusion who underwent ADAPT as the first and only intention-to-treat endovascular approach in 2010–2017 were matched 1-to-2 with patients treated by stent retriever thrombectomy. Demographic, imaging, procedural, and clinical data were collected retrospectively for between-group analysis.ResultsThe study group included 39 patients (51% male) of mean age 67?years; median National Institute of Health Stroke Scale score was 16. Compared to the stent-retriever group (N?=?80), the ADAPT group had a significantly shorter puncture-to-recanalization time (58?min vs 76?min,P?=?0.05), higher rate of good recanalization (TICI 2B/3 95% vs 86%,P?=?0.15), and significantly higher rate of early neurological improvement (64% vs 43% of patients,P?