Safety and efficacy of a direct aspiration first-pass technique with large-bore catheters for acute ischemic stroke in vietnam: Experience of a single center

Vu Luu; Le Kien; Tran Tuan; Nguyen Anh; Nguyen Thien; Nguyen Trang; Dao Phuong; Mai Ton; Pham Thong; Le Cong; Vu Trieu; Nguyen Manh; Tran Cuong

doi:10.4103/ajns.AJNS_263_19

Asian Journal of Neurosurgery, Table of Contents

CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(02): 306-310
DOI: 10.4103/ajns.AJNS_263_19

Original Article

Safety and efficacy of a direct aspiration first-pass technique with large-bore catheters for acute ischemic stroke in vietnam: Experience of a single center

Vu Luu

Radiology Faculty, Bach Mai Radiology Center, Bach Mai Hospital, Hanoi Medical University, Hanoi

,

Le Kien

Radiology Faculty, Bach Mai Radiology Center, Bach Mai Hospital, Hanoi Medical University, Hanoi

,

Tran Tuan

Radiology Faculty, Bach Mai Radiology Center, Bach Mai Hospital, Hanoi Medical University, Hanoi

,

Nguyen Anh

Radiology Faculty, Bach Mai Radiology Center, Bach Mai Hospital, Hanoi Medical University, Hanoi

,

Nguyen Thien

Radiology Faculty, Bach Mai Radiology Center, Bach Mai Hospital, Hanoi Medical University, Hanoi

,

Nguyen Trang

Radiology Faculty, Bach Mai Radiology Center, Bach Mai Hospital, Hanoi Medical University, Hanoi

,

Dao Phuong

Radiology Faculty, Bach Mai Radiology Center, Bach Mai Hospital, Hanoi Medical University, Hanoi

,

Mai Ton

¹Department of Emergency, Bach Mai Hospital, Hanoi

,

Pham Thong

Radiology Faculty, Bach Mai Radiology Center, Bach Mai Hospital, Hanoi Medical University, Hanoi

,

Le Cong

Radiology Faculty, Bach Mai Radiology Center, Bach Mai Hospital, Hanoi Medical University, Hanoi

,

Vu Trieu

Radiology Faculty, Bach Mai Radiology Center, Bach Mai Hospital, Hanoi Medical University, Hanoi

,

Nguyen Manh

Radiology Faculty, Bach Mai Radiology Center, Bach Mai Hospital, Hanoi Medical University, Hanoi

,

Tran Cuong

Radiology Faculty, Bach Mai Radiology Center, Bach Mai Hospital, Hanoi Medical University, Hanoi

› Author Affiliations

Abstract

Purpose: The purpose of this study was to evaluate the safety and efficacy of mechanical thrombectomy with a direct aspiration first-pass technique (ADAPT) using large-bore catheters in patients with acute ischemic stroke due to large vessel occlusion (LVO) in a hospital in Vietnam. Methods: This was a retrospective review of patients with acute ischemic stroke due to LVO who were diagnosed and underwent mechanical thrombectomy using ADAPT with large-bore catheters at Bach Mai Hospital from January 2017 to June 2018. Results: Seventy-three patients (47.9% female; age: 61.29 ± 14.49 years) met study criteria. The average procedure duration was 45.09 ± 38.26 min. Successful recanalization post-ADAPT (thrombolysis in cerebral infarction 2b-3) was achieved in 72.6% (53/73) of patients. Good functional outcome (Modified Rankin Scale 0–2) at 3 months was achieved in 50.7% (37/73), with poor functional outcome in 24.7% (18/73). The 90-day mortality rate was 24.7% (18/73). The hemorrhagic transformation rate was 31.6%, in which 19.2% were symptomatic. Vessel perforation occurred in 5.5% (4/73) of patients but in all cases was associated with the guidewire and not the reperfusion catheter. Vessel dissection occurred in 1.4% (1/73) and vasospasm in 5.5% (4/73) of patients. Conclusion: Mechanical thrombectomy using ADAPT with large-bore catheters for acute ischemic stroke due to LVO is a method that yielded good results in recanalization and clinical recovery in a Vietnamese patient population.

Key-words:

Acute ischemic stroke - Bach Mai Hospital - mechanical thrombectomy - thrombosis

Full Text

References

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