Initial Results of Management for Acute Ischemic Stroke due to Large Vessel Occlusion by a Direct Aspiration First Pass Technique at a Vietnamese Hospital

Le Van Phuoc; Nguyen Huynh Nhat Tuan; Le Van Khoa; Nguyen Van Tien Bao; Pham Dang Tu; Duong Dinh Hoan; Pham Thi Ngoc Thao; Nguyen Van Khoi

doi:10.4103/ajns.AJNS_258_19

Initial Results of Management for Acute Ischemic Stroke due to Large Vessel Occlusion by a Direct Aspiration First Pass Technique at a Vietnamese Hospital

Asian J Neurosurg. 2020 Feb 25;15(1):65-69. doi: 10.4103/ajns.AJNS_258_19. eCollection 2020 Jan-Mar.

Authors

Le Van Phuoc¹, Nguyen Huynh Nhat Tuan¹, Le Van Khoa¹, Nguyen Van Tien Bao¹, Pham Dang Tu¹, Duong Dinh Hoan¹, Pham Thi Ngoc Thao², Nguyen Van Khoi³

Affiliations

¹ Department of Radiology, Cho Ray Hospital, Ho Chi Minh, Vietnam.
² Department of Intensive Care, Cho Ray Hospital, Ho Chi Minh, Vietnam.
³ Department of Vascular Surgery, Cho Ray Hospital, Ho Chi Minh, Vietnam.

Abstract

Background: The development of novel revascularization devices has improved procedural and clinical outcomes in acute ischemic stroke (AIS). A direct aspiration first pass technique (ADAPT) has been introduced as a rapid simple method for achieving good recanalization and clinical outcomes using large bore aspiration catheters in the treatment of AIS due to large vessel occlusion (LVO).

Objectives: The aim of this study was to assess the safety and efficacy of ADAPT in the treatment of AIS due to LVO in the Vietnamese patient population.

Materials and methods: A retrospective analysis of a hospital database was conducted on all patients undergoing stroke therapy with the ADAPT technique at the institution from January 2017 to December 2017. Efficacy and safety were evaluated by the variables: revascularization rates (thrombolysis in cerebral infarction [TICI] score), time to revascularization, procedural complications, and clinical outcomes (modified Rankin scale [mRS] score) at the 90-day follow-up visit.

Results: From the database review, 37 AIS patients treated with ADAPT were identified. The mean NIHSS score at presentation was 17.3 and improved to 8.9 at discharged. The average time arterial puncture to revascularization was 32.5 min. TICI 2b/3 revascularization was achieved in 30/37 (81.1%) patients, good clinical outcomes were achieved (mRS 0-2) in 21/37 (56.7%) patients, and mortality rate was 6/37 (16.2%) during follow-up.

Conclusions: ADAPT utilizing large bore aspiration catheters appears to be a fast, simple, safe, and effective method for the management of AIS in the Vietnamese patient population.

Keywords: A direct aspiration first pass technique; endovascular management; large vessel occlusion.