A Study of Efficacy and Outcomes of Two Techniques of Mechanical Thrombectomy in Acute Ischemic Stroke

• Published in: Indian journal of neurosurgery
• Main Authors: Shavi, Tejesh, Pandey, Paritosh, Acharya, Ullas V
• Format: Journal Article
• Language: English
• Published: Thieme Medical Publishers, Inc 08.02.2024
• Subjects: aspiration thrombectomy; ischemic stroke; mechanical thrombectomy; reperfusion; stent retrieval thrombectomy
• ISSN: 2277-954X; 2277-9167
• DOI: 10.1055/s-0043-1778689

Abstract Background Endovascular mechanical thrombectomy (A Direct Aspiration First Pass Technique [ADAPT] and Solitaire stent retrieval techniques) as an emergency reperfusion therapy in acute ischemic stroke patients avoids secondary brain insult and thereby prevents permanent neurological deficits. As studies comparing the two thrombectomy procedures are scarce, we evaluated their efficacy. Methods In this prospective observational study done at Manipal Hospitals Bangalore, 75 patients were separated into two groups based on the final reperfusion technique employed: ADAPT group with 39 patients who underwent contact aspiration technique and Solitaire group with 36 patients who underwent stent retrieval thrombectomy. The rate of successful reperfusion (modified treatment in cerebral infarction scores [mTICI]); functional outcomes (modified Rankin scale [mRS] and National Institutes of Health Stroke Scale [NIHSS]) at 24 hours, 1 month and 3 months postintervention; and the adverse events were compared between the two groups. Results Successful reperfusion was significantly higher in the ADAPT group. Mean NIHSS and mRS scores reduced significantly postintervention for both groups, but was greater for the ADAPT group, while mortality and other adverse events were significantly greater in the solitaire group. Conclusion Mechanical thrombectomy is an effective reperfusion therapy for acute ischemic stroke patients. Comparing the two techniques revealed better outcomes for ADAPT, than stent retrieval technique.