Phuoc Le Van, Tuan Nguyen Huynh Nhat, Khoa Le Van, Bao Nguyen Van Tien, Tu Pham Dang, Hoan Duong Dinh, Thao Pham Thi Ngoc, Khoi Nguyen Van
Department of Radiology, Cho Ray Hospital, Ho Chi Minh, Vietnam.
Department of Intensive Care, Cho Ray Hospital, Ho Chi Minh, Vietnam.
Asian J Neurosurg. 2020 Feb 25;15(1):65-69. doi: 10.4103/ajns.AJNS_258_19. eCollection 2020 Jan-Mar.
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).
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.
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.
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.
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.
新型血管再通装置的发展改善了急性缺血性卒中（AIS）的手术和临床结局。直接抽吸首次通过技术（ADAPT）已作为一种快速简便的方法被引入，用于在治疗因大血管闭塞（LVO）导致的AIS时，使用大口径抽吸导管实现良好的再通和临床结局。
本研究的目的是评估ADAPT在越南患者群体中治疗因LVO导致的AIS的安全性和有效性。
对2017年1月至2017年12月在该机构接受ADAPT技术卒中治疗的所有患者的医院数据库进行回顾性分析。通过以下变量评估疗效和安全性：再通率（脑梗死溶栓[TICI]评分）、再通时间、手术并发症以及90天随访时的临床结局（改良Rankin量表[mRS]评分）。
通过数据库回顾，确定了37例接受ADAPT治疗的AIS患者。就诊时的平均美国国立卫生研究院卒中量表（NIHSS）评分为17.3，出院时改善至8.9。从动脉穿刺到再通的平均时间为32.5分钟。30/37（81.1%）的患者实现了TICI 2b/3级再通，21/37（56.7%）的患者获得了良好的临床结局（mRS 0 - 2），随访期间死亡率为6/37（16.2%）。
在越南患者群体中，使用大口径抽吸导管的ADAPT似乎是一种快速、简单、安全且有效的AIS治疗方法。
