Abstract
Direct aspiration, a thrombectomy approach that originally evolved from a modified stent retriever-based technique, is now accepted as a frontline modality. We outline the evolution of thrombectomy techniques leading to ADAPT (A Direct Aspiration First-Pass Technique), as well as the current literature to support its use.
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References
Albers GW, et al. Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging. N Engl J Med. 2018;378(8):708–18.
Nogueira RG, et al. Thrombectomy 6 to 24 hours after stroke with a mismatch between deficit and infarct. N Engl J Med. 2018;378(1):11–21.
Goyal M, et al. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet. 2016;387(10029):1723–31.
Fransen PS, et al. MR CLEAN, a multicenter randomized clinical trial of endovascular treatment for acute ischemic stroke in the Netherlands: study protocol for a randomized controlled trial. Trials. 2014;15:343.
Saver JL, et al. Solitaire with the intention for thrombectomy as primary endovascular treatment for acute ischemic stroke (SWIFT PRIME) trial: protocol for a randomized, controlled, multicenter study comparing the solitaire revascularization device with IV tPA with IV tPA alone in acute ischemic stroke. Int J Stroke. 2015;10(3):439–48.
Turk AS, et al. Initial clinical experience with the ADAPT technique: a direct aspiration first pass technique for stroke thrombectomy. J Neurointerv Surg. 2013;6:231.
Alawieh A, et al. Lessons learned over more than 500 stroke thrombectomies using ADAPT with increasing aspiration catheter size. Neurosurgery. 2018;86:61.
Vargas J, et al. Long term experience using the ADAPT technique for the treatment of acute ischemic stroke. J Neurointerv Surg. 2017;9(5):437–41.
Vargas J, et al. Experience with A Direct Aspiration First Pass Technique (ADAPT) for thrombectomy in distal cerebral artery occlusions causing acute ischemic stroke. World Neurosurg. 2017;99:31–6.
Turk AS 3rd, et al. Aspiration thrombectomy versus stent retriever thrombectomy as first-line approach for large vessel occlusion (COMPASS): a multicentre, randomised, open label, blinded outcome, non-inferiority trial. Lancet. 2019;393(10175):998–1008.
Lapergue B, et al. Effect of endovascular contact aspiration vs stent retriever on revascularization in patients with acute ischemic stroke and large vessel occlusion: the ASTER randomized clinical trial. JAMA. 2017;318(5):443–52.
Bose A, et al. The Penumbra system: a mechanical device for the treatment of acute stroke due to thromboembolism. AJNR Am J Neuroradiol. 2008;29(7):1409–13.
Nogueira RG, et al. Trevo versus Merci retrievers for thrombectomy revascularisation of large vessel occlusions in acute ischaemic stroke (TREVO 2): a randomised trial. Lancet. 2012;380(9849):1231–40.
Tenser MS, Amar AP, Mack WJ. Mechanical thrombectomy for acute ischemic stroke using the MERCI retriever and Penumbra aspiration systems. World Neurosurg. 2011;76(6 Suppl):S16–23.
Smith WS. Safety of mechanical thrombectomy and intravenous tissue plasminogen activator in acute ischemic stroke. Results of the multi Mechanical Embolus Removal in Cerebral Ischemia (MERCI) trial, part I. AJNR Am J Neuroradiol. 2006;27(6):1177–82.
Yoo AJ, et al. The penumbra stroke system: a technical review. J Neurointerv Surg. 2012;4(3):199–205.
Spiotta AM, et al. The versatile distal access catheter: the Cleveland Clinic experience. Neurosurgery. 2011;68(6):1677–86; discussion 1686.
Turk AS 3rd, et al. An investigation of the cost and benefit of mechanical thrombectomy for endovascular treatment of acute ischemic stroke. J Neurointerv Surg. 2014;6(1):77–80.
Turk AS, et al. Initial clinical experience with the ADAPT technique: a direct aspiration first pass technique for stroke thrombectomy. J Neurointerv Surg. 2018;10(Suppl 1):i20–5.
Frei D, et al. The SPEED study: initial clinical evaluation of the Penumbra novel 054 Reperfusion Catheter. J Neurointerv Surg. 2013;5(Suppl 1):i74–6.
Hui FK, et al. Merci retrievers as access adjuncts for reperfusion catheters: the grappling hook technique. Neurosurgery. 2012;70(2):456–60; discussion 460.
Turk A, et al. Initial experience with distal guide catheter placement in the treatment of cerebrovascular disease: clinical safety and efficacy. J Neurointerv Surg. 2012;5:247.
Turk AS, et al. ADAPT FAST study: a direct aspiration first pass technique for acute stroke thrombectomy. J Neurointerv Surg. 2014;6(4):260–4.
Devlin TG, et al. The Merci retrieval system for acute stroke: the Southeast Regional Stroke Center experience. Neurocrit Care. 2007;6(1):11–21.
Delgado Almandoz JE, et al. Comparison of clinical outcomes in patients with acute ischemic strokes treated with mechanical thrombectomy using either Solumbra or ADAPT techniques. J Neurointerv Surg. 2016;8(11):1123–8.
Jovin TG, et al. Diffusion-weighted imaging or computerized tomography perfusion assessment with clinical mismatch in the triage of wake up and late presenting strokes undergoing neurointervention with Trevo (DAWN) trial methods. Int J Stroke. 2017;12(6):641–52.
Campbell BC, et al. Endovascular therapy for ischemic stroke with perfusion-imaging selection. N Engl J Med. 2015;372(11):1009–18.
Jovin TG, et al. Thrombectomy within 8 hours after symptom onset in ischemic stroke. N Engl J Med. 2015;372(24):2296–306.
Powers WJ, et al. 2018 guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2018;49(3):e46–e110.
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Al Kasab, S., Spiotta, A.M. (2021). Direct Aspiration Thrombectomy for Acute Stroke: Evolution of Technique and Evidence. In: Hui, F.K., Spiotta, A.M., Alexander, M.J., Hanel, R.A., Baxter, B.W. (eds) 12 Strokes. Springer, Cham. https://doi.org/10.1007/978-3-030-56857-3_8
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DOI: https://doi.org/10.1007/978-3-030-56857-3_8
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