Objectives

This study aimed to assess the clinical usefulness of a direct aspiration first pass technique as a first-line strategy for mechanical thrombectomy in posterior circulation.

Materials and methods

We examined 34 consecutive patients treated with mechanical thrombectomy for acute vertebrobasilar artery occlusion. Procedural and clinical outcomes were assessed and compared between patients treated with a direct aspiration first pass technique first-line strategy (ADAPT group) and stent retriever system first-line strategy (stent retriever group).

Results

Overall, successful reperfusion, complete reperfusion, and first-pass effects were achieved in 94.1%, 61.8%, and 50% of patients with acute ischemic stroke in vertebra-basilar artery occlusion treated with mechanical thrombectomy, respectively. The ADAPT group required a significantly shorter procedural time (p=.015) and fewer attempts (p=.0498) to achieve successful recanalization than the stent retriever group. The ADAPT group also tended to show better recanalization rates and first-pass effects than the stent retriever group. The rates of favorable outcomes seemed to be better, although insignificant, in the ADAPT group than in the stent retriever group (52.2% vs. 27.3%, p=.217). However, a significant correlation between the time required for reperfusion and clinical outcome was detected, and this will serve as the rationale for encouraging a direct aspiration first pass technique as a first-line strategy in the acute vertebra-basilar artery.

Conclusions

The a direct aspiration first pass technique first-line strategy for mechanical thrombectomy in posterior circulation may achieve successful recanalization with fewer attempts and shorter durations than the stent retriever first-line strategy.

中文翻译：

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椎基底动脉闭塞的直接抽吸首通技术：与支架取出器的回顾性比较

目标

本研究旨在评估直接抽吸首过技术作为后循环机械取栓一线策略的临床有效性。

材料和方法

我们检查了 34 名连续接受机械取栓治疗急性椎基底动脉闭塞的患者。评估并比较接受直接抽吸首过技术一线策略（ADAPT 组）和支架取出系统一线策略（支架取出器组）治疗的患者的程序和临床结果。

结果

总体而言，在接受机械取栓治疗的椎基底动脉闭塞的急性缺血性卒中患者中，成功再灌注、完全再灌注和首过效应分别达到 94.1%、61.8% 和 50%。与支架取栓器组相比，ADAPT 组需要明显更短的手术时间 (p=.015) 和更少的尝试 (p=.0498) 来实现成功再通。ADAPT 组也倾向于显示出比支架取出器组更好的再通率和首过效应。ADAPT 组的良好结果率似乎比支架取栓器组更好，但不显着（52.2% 对 27.3%，p=0.217）。然而，检测到再灌注所需时间与临床结果之间存在显着相关性，

结论

与支架取栓器一线策略相比，直接抽吸首过技术作为后循环机械取栓术的一线策略，可以通过更少的尝试和更短的持续时间实现成功的再通。