Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
Department of Radiology and Neuroradiology, University Hospital of Cologne, Cologne, Germany.
J Neurointerv Surg. 2017 Dec;9(12):1223-1227. doi: 10.1136/neurintsurg-2016-012812. Epub 2016 Dec 20.
The direct aspiration first pass technique (ADAPT) has been introduced as a rapid and safe endovascular treatment strategy in patients with ischemic stroke.
To determine the technical feasibility, safety, and functional outcome with ADAPT using the new large-bore 6F SOFIA Plus catheter.
A retrospective analysis of prospectively collected data from six university hospitals was performed. The following parameters of all acute stroke procedures (June 2015- January 2016) using the SOFIA Plus catheter were analyzed: accessibility of the thrombus with the catheter, recanalization success (Thrombolysis in Cerebral Infarction ≥2b), time to recanalization, procedure-related complications. Furthermore, National Institutes of Health Stroke Scale (NIHSS) scores at presentation and discharge and the modified Rankin scale (mRS) score at 90 days were recorded.
85 patients were treated using the SOFIA Plus catheter. The occlusion site was the anterior circulation in 94.1%. Median baseline NIHSS score was 18. In 64.7%, ADAPT alone was successful after a median procedure time of 21 min. With additional use of stent retrievers in the remaining cases, the recanalization rate was 96.5%. No catheter-related complications such as dissections were observed. Thrombus migration to a new vascular territory occurred in 4.7% and symptomatic hemorrhage in 4.7%. After 3 months, mRS 0-2 was achieved in 49.4%. Mortality rate was 20%.
In the majority of cases, thrombus aspiration using the SOFIA Plus catheter results in successful recanalization after a short procedure time. With additional use of stent retrievers, a high recanalization rate can be achieved (96.5%). The complication rate was in line with those of previous publications.
直接抽吸首次通过技术（ADAPT）已被引入作为一种快速且安全的血管内治疗策略，适用于缺血性脑卒中患者。
使用新型大口径 6F SOFIA Plus 导管确定 ADAPT 的技术可行性、安全性和功能结果。
对来自六所大学医院的前瞻性采集数据进行回顾性分析。分析所有使用 SOFIA Plus 导管的急性脑卒中手术的以下参数：导管对血栓的可及性、再通成功率（脑梗死溶栓≥2b）、再通时间、与手术相关的并发症。此外，记录发病时和出院时的国立卫生研究院卒中量表（NIHSS）评分以及 90 天时的改良 Rankin 量表（mRS）评分。
85 例患者使用 SOFIA Plus 导管进行治疗。闭塞部位在前循环的占 94.1%。中位基线 NIHSS 评分为 18。在 64.7%的患者中，ADAPT 单独治疗后，中位手术时间为 21 分钟，即取得成功。在其余病例中，额外使用支架取栓器后，再通率为 96.5%。未观察到与导管相关的并发症，如夹层。4.7%的患者发生血栓迁移至新的血管区域，4.7%的患者发生症状性出血。3 个月后，mRS 0-2 的比例为 49.4%。死亡率为 20%。
在大多数情况下，SOFIA Plus 导管的血栓抽吸术可在短时间内实现成功再通。通过额外使用支架取栓器，可实现较高的再通率（96.5%）。并发症发生率与之前的研究报告一致。
