Efficacy and safety of a direct aspiration first-pass thrombectomy technique in treating atherosclerotic acute intracranial large vessel occlusion

Objective To investigate the efficacy and safety of a direct aspiration first-pass thrombectomy (ADAPT) technique in treating acute atherosclerotic intracranial large vessel occlusion. Methods Seventy-two patients with acute atherosclerotic intracranial large vessel occlusion underwent endovascular treatment in our hospital from March 2018 to March 2019 were chosen in our study; ADAPT technique was used in 24 patients, and Solitaire stent combined with penumbra suction catheter extraction (Solumbra) technique was used in 48 patients. Remedial measures were adopted after the failure of recanalization. Modified intraoperative cerebral infarction thrombolysis grading was used for vascular recanalization evaluation. The prognoses of the patients were determined according to modified Rankin scale (mRS) scores 3 months after operation, and the efficacy and safety of the patients in the two groups were compared. Results As compared with patients in the Solumbra group, patients in the ADAPT group had statistically shorter time from femoral artery puncture to reflow (P 0.05). The final recanalization rates of patients in Solumbra group and ADAPT group were 83.33% and 75.00%, without statistically significant difference (P>0.05). There was no significant difference in proportion of patients with good prognosis, incidence of perioperative symptomatic intracranial hemorrhage and mortality between the two groups (P>0.05). Conclusion For patients with acute atherosclerotic intracranial large vessel occlusion, endovascular treatment with ADAPT technique is comparable with Solumbra technique. Key words: Atherosclerosis; Acute intracranial large vessel occlusion; A direct aspiration first-pass thrombectomy technique; Solitaire stent combined with penumbra suction catheter extraction technique