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<meta name="DC.Title" content="A Direct Aspiration, First Pass Technique (ADAPT) versus Stent Retrievers for Acute Stroke Therapy: An Observational Comparative Study" />
<meta name="DC.Identifier" content="10.3174/ajnr.A4840" />
<meta name="DC.Date" content="2016-10-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2016 by American Journal of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Mechanical thrombectomy with stent retrievers is now the standard therapy for selected patients with ischemic stroke. The technique of A Direct Aspiration, First Pass Technique for the Endovascular Treatment of Stroke (ADAPT) appears promising with a high rate of recanalization. We compared ADAPT versus stent retrievers (the Solitaire device) for efficacy and safety as a front-line endovascular procedure.

MATERIALS AND METHODS: We analyzed 243 consecutive patients with large intracranial artery occlusions of the anterior circulation, treated within 6 hours with mechanical thrombectomy by either ADAPT or the Solitaire stent. Th primary outcome was complete recanalization (modified TICI ≥ 2b); secondary outcomes included complication rates and procedural and clinical outcomes.

RESULTS: From November 2012 to June 2014, 119 patients were treated with stent retriever (Solitaire FR) and 124 by using the ADAPT with Penumbra reperfusion catheters. The median baseline NIHSS score was the same for both groups (Solitaire, 17 [interquartile range, 11–21] versus ADAPT, 17 [interquartile range, 12–21]). Time from groin puncture to recanalization (Solitaire, 50 minutes [range, 25–80 minutes] versus ADAPT, 45 minutes [range, 27–70 minutes], P = .42) did not differ significantly. However, compared with the Solitaire group, patients treated with ADAPT achieved higher final recanalization rates (82.3% versus 68.9%; adjusted relative risk, 1.18; 95% CI, 1.02–1.37; P = .022), though differences in clinical outcomes between the cohorts were not significant. Use of an adjunctive device was more frequent in the ADAPT group (45.2% versus 13.5%, P &lt; .0001). The rate of embolization in new territories or symptomatic hemorrhage did not differ significantly between the 2 groups.

CONCLUSIONS: Front-line ADAPT achieved higher recanalization rates than the Solitaire device. Further randomized controlled trials are warranted to define the best strategy for mechanical thrombectomy.

ADAPT
:   A Direct Aspiration, First Pass Technique for the Endovascular Treatment of Stroke
MT
:   mechanical thrombectomy
mTICI
:   modified TICI" />
<meta name="DC.Contributor" content="B. Lapergue" />
<meta name="DC.Contributor" content="R. Blanc" />
<meta name="DC.Contributor" content="P. Guedin" />
<meta name="DC.Contributor" content="J.-P. Decroix" />
<meta name="DC.Contributor" content="J. Labreuche" />
<meta name="DC.Contributor" content="C. Preda" />
<meta name="DC.Contributor" content="B. Bartolini" />
<meta name="DC.Contributor" content="O. Coskun" />
<meta name="DC.Contributor" content="H. Redjem" />
<meta name="DC.Contributor" content="M. Mazighi" />
<meta name="DC.Contributor" content="F. Bourdain" />
<meta name="DC.Contributor" content="G. Rodesch" />
<meta name="DC.Contributor" content="M. Piotin" />
<meta name="article:published_time" content="2016-10-01" />
<meta name="article:section" content="INTERVENTIONAL" />
<meta name="citation_title" content="A Direct Aspiration, First Pass Technique (ADAPT) versus Stent Retrievers for Acute Stroke Therapy: An Observational Comparative Study" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Mechanical thrombectomy with stent retrievers is now the standard therapy for selected patients with ischemic stroke. The technique of A Direct Aspiration, First Pass Technique for the Endovascular Treatment of Stroke (ADAPT) appears promising with a high rate of recanalization. We compared ADAPT versus stent retrievers (the Solitaire device) for efficacy and safety as a front-line endovascular procedure.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;We analyzed 243 consecutive patients with large intracranial artery occlusions of the anterior circulation, treated within 6 hours with mechanical thrombectomy by either ADAPT or the Solitaire stent. Th primary outcome was complete recanalization (modified TICI ≥ 2b); secondary outcomes included complication rates and procedural and clinical outcomes.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;From November 2012 to June 2014, 119 patients were treated with stent retriever (Solitaire FR) and 124 by using the ADAPT with Penumbra reperfusion catheters. The median baseline NIHSS score was the same for both groups (Solitaire, 17 [interquartile range, 11–21] versus ADAPT, 17 [interquartile range, 12–21]). Time from groin puncture to recanalization (Solitaire, 50 minutes [range, 25–80 minutes] versus ADAPT, 45 minutes [range, 27–70 minutes], &lt;i&gt;P&lt;/i&gt; = .42) did not differ significantly. However, compared with the Solitaire group, patients treated with ADAPT achieved higher final recanalization rates (82.3% versus 68.9%; adjusted relative risk, 1.18; 95% CI, 1.02–1.37; &lt;i&gt;P&lt;/i&gt; = .022), though differences in clinical outcomes between the cohorts were not significant. Use of an adjunctive device was more frequent in the ADAPT group (45.2% versus 13.5%, &lt;i&gt;P&lt;/i&gt; &amp;lt; .0001). The rate of embolization in new territories or symptomatic hemorrhage did not differ significantly between the 2 groups.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Front-line ADAPT achieved higher recanalization rates than the Solitaire device. Further randomized controlled trials are warranted to define the best strategy for mechanical thrombectomy.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
<meta name="citation_publisher" content="American Journal of Neuroradiology" />
<meta name="citation_publication_date" content="2016/10/01" />
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<meta name="citation_article_type" content="Research Article" />
<meta name="citation_section" content="INTERVENTIONAL" />
<meta name="citation_firstpage" content="1860" />
<meta name="citation_lastpage" content="1865" />
<meta name="citation_author" content="B. Lapergue" />
<meta name="citation_author_institution" content="aFrom the Division of Neurology (B.L., J.-P.D., F.B.), Stroke Center, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France" />
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<meta name="citation_author" content="R. Blanc" />
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<meta name="twitter:title" content="A Direct Aspiration, First Pass Technique (ADAPT) versus Stent Retrievers for Acute Stroke Therapy: An Observational Comparative Study" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Mechanical thrombectomy with stent retrievers is now the standard therapy for selected patients with ischemic stroke. The technique of A Direct Aspiration, First Pass Technique for the Endovascular Treatment of Stroke (ADAPT) appears promising with a high rate of recanalization. We compared ADAPT versus stent retrievers (the Solitaire device) for efficacy and safety as a front-line endovascular procedure.

MATERIALS AND METHODS: We analyzed 243 consecutive patients with large intracranial artery occlusions of the anterior circulation, treated within 6 hours with mechanical thrombectomy by either ADAPT or the Solitaire stent. Th primary outcome was complete recanalization (modified TICI ≥ 2b); secondary outcomes included complication rates and procedural and clinical outcomes.

RESULTS: From November 2012 to June 2014, 119 patients were treated with stent retriever (Solitaire FR) and 124 by using the ADAPT with Penumbra reperfusion catheters. The median baseline NIHSS score was the same for both groups (Solitaire, 17 [interquartile range, 11–21] versus ADAPT, 17 [interquartile range, 12–21]). Time from groin puncture to recanalization (Solitaire, 50 minutes [range, 25–80 minutes] versus ADAPT, 45 minutes [range, 27–70 minutes], P = .42) did not differ significantly. However, compared with the Solitaire group, patients treated with ADAPT achieved higher final recanalization rates (82.3% versus 68.9%; adjusted relative risk, 1.18; 95% CI, 1.02–1.37; P = .022), though differences in clinical outcomes between the cohorts were not significant. Use of an adjunctive device was more frequent in the ADAPT group (45.2% versus 13.5%, P &lt; .0001). The rate of embolization in new territories or symptomatic hemorrhage did not differ significantly between the 2 groups.

CONCLUSIONS: Front-line ADAPT achieved higher recanalization rates than the Solitaire device. Further randomized controlled trials are warranted to define the best strategy for mechanical thrombectomy.

ADAPT
:   A Direct Aspiration, First Pass Technique for the Endovascular Treatment of Stroke
MT
:   mechanical thrombectomy
mTICI
:   modified TICI" />
<meta name="og-title" property="og:title" content="A Direct Aspiration, First Pass Technique (ADAPT) versus Stent Retrievers for Acute Stroke Therapy: An Observational Comparative Study" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/37/10/1860" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Mechanical thrombectomy with stent retrievers is now the standard therapy for selected patients with ischemic stroke. The technique of A Direct Aspiration, First Pass Technique for the Endovascular Treatment of Stroke (ADAPT) appears promising with a high rate of recanalization. We compared ADAPT versus stent retrievers (the Solitaire device) for efficacy and safety as a front-line endovascular procedure.

MATERIALS AND METHODS: We analyzed 243 consecutive patients with large intracranial artery occlusions of the anterior circulation, treated within 6 hours with mechanical thrombectomy by either ADAPT or the Solitaire stent. Th primary outcome was complete recanalization (modified TICI ≥ 2b); secondary outcomes included complication rates and procedural and clinical outcomes.

RESULTS: From November 2012 to June 2014, 119 patients were treated with stent retriever (Solitaire FR) and 124 by using the ADAPT with Penumbra reperfusion catheters. The median baseline NIHSS score was the same for both groups (Solitaire, 17 [interquartile range, 11–21] versus ADAPT, 17 [interquartile range, 12–21]). Time from groin puncture to recanalization (Solitaire, 50 minutes [range, 25–80 minutes] versus ADAPT, 45 minutes [range, 27–70 minutes], P = .42) did not differ significantly. However, compared with the Solitaire group, patients treated with ADAPT achieved higher final recanalization rates (82.3% versus 68.9%; adjusted relative risk, 1.18; 95% CI, 1.02–1.37; P = .022), though differences in clinical outcomes between the cohorts were not significant. Use of an adjunctive device was more frequent in the ADAPT group (45.2% versus 13.5%, P &lt; .0001). The rate of embolization in new territories or symptomatic hemorrhage did not differ significantly between the 2 groups.

CONCLUSIONS: Front-line ADAPT achieved higher recanalization rates than the Solitaire device. Further randomized controlled trials are warranted to define the best strategy for mechanical thrombectomy.

ADAPT
:   A Direct Aspiration, First Pass Technique for the Endovascular Treatment of Stroke
MT
:   mechanical thrombectomy
mTICI
:   modified TICI" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node14596--5" data-node-nid="14596" id="top-node-14596--61641380978" data-pisa="ajnr;37/10/1860" data-pisa-master="ajnr;ajnr.A4840" data-apath="/ajnr/37/10/1860.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">INTERVENTIONAL</span></span></div>
  
      <div class="highwire-cite-access"><span class="highwire-citation-access highwire-citation-access-check" data-pisa-id="ajnr;ajnr.A4840" data-atom-uri="/ajnr/37/10/1860.atom" data-request-view="full"></span></div>
  
      <h1 class="highwire-cite-title" id="page-title">A Direct Aspiration, First Pass Technique (ADAPT) versus Stent Retrievers for Acute Stroke Therapy: An Observational Comparative Study</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">B. Lapergue</span>, <span class="highwire-citation-author" data-delta="1">R. Blanc</span>, <span class="highwire-citation-author" data-delta="2">P. Guedin</span>, <span class="highwire-citation-author" data-delta="3">J.-P. Decroix</span>, <span class="highwire-citation-author" data-delta="4">J. Labreuche</span>, <span class="highwire-citation-author" data-delta="5">C. Preda</span>, <span class="highwire-citation-author" data-delta="6">B. Bartolini</span>, <span class="highwire-citation-author" data-delta="7">O. Coskun</span>, <span class="highwire-citation-author" data-delta="8">H. Redjem</span>, <span class="highwire-citation-author" data-delta="9">M. Mazighi</span>, <span class="highwire-citation-author" data-delta="10">F. Bourdain</span>, <span class="highwire-citation-author" data-delta="11">G. Rodesch</span> and <span class="highwire-citation-author" data-delta="12">M. Piotin</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">October 2016,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">37 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1860-1865; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A4840 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-14596--61641380978" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">B. Lapergue </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Division of Neurology (B.L., J.-P.D., F.B.), Stroke Center, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=B.%2BLapergue%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Lapergue%20B&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AB.%2BLapergue%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-8993-2175" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for B. Lapergue</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">R. Blanc </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Diagnostic and Interventional Neuroradiology (R.B., B.B., H.R., M.P.), Rothschild Foundation, Paris, France</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=R.%2BBlanc%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Blanc%20R&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AR.%2BBlanc%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-0086-8614" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for R. Blanc</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">P. Guedin </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Diagnostic and Interventional Neuroradiology (P.G., O.C., G.R.), Foch Hospital, Suresnes, France</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=P.%2BGuedin%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Guedin%20P&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AP.%2BGuedin%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-9694-6102" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for P. Guedin</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">J.-P. Decroix </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Division of Neurology (B.L., J.-P.D., F.B.), Stroke Center, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.-P.%2BDecroix%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Decroix%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJ.-P.%2BDecroix%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-9064-1503" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J.-P. Decroix</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">J. Labreuche </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Department of Biostatistics (J.L.), Univiversity of Lille, Centre Hospitalier Universitaire Lille, Santé Publique: Epidémiologie et Qualité des Soins, Lille, France</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.%2BLabreuche%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Labreuche%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJ.%2BLabreuche%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-3384-0423" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J. Labreuche</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">C. Preda </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>e</span>Laboratoire de Mathématiques Paul Painlevé (C.P.), Unité Mixte de Recherche CNRS 8524, Lille, France</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=C.%2BPreda%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Preda%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AC.%2BPreda%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-6787-7374" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for C. Preda</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">B. Bartolini </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Diagnostic and Interventional Neuroradiology (R.B., B.B., H.R., M.P.), Rothschild Foundation, Paris, France</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=B.%2BBartolini%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Bartolini%20B&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AB.%2BBartolini%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-6055-0221" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for B. Bartolini</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">O. Coskun </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Diagnostic and Interventional Neuroradiology (P.G., O.C., G.R.), Foch Hospital, Suresnes, France</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=O.%2BCoskun%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Coskun%20O&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AO.%2BCoskun%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-9968-358X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for O. Coskun</a></li></ul></div><div class="author-tooltip-8"><div class="author-tooltip-name">H. Redjem </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Diagnostic and Interventional Neuroradiology (R.B., B.B., H.R., M.P.), Rothschild Foundation, Paris, France</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=H.%2BRedjem%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Redjem%20H&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AH.%2BRedjem%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-6943-9922" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for H. Redjem</a></li></ul></div><div class="author-tooltip-9"><div class="author-tooltip-name">M. Mazighi </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>f</span>Department of Neurology and Stroke Center (M.M.), Lariboisière Hospital, Paris, France.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.%2BMazighi%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Mazighi%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.%2BMazighi%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0003-0911-8999" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M. Mazighi</a></li></ul></div><div class="author-tooltip-10"><div class="author-tooltip-name">F. Bourdain </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Division of Neurology (B.L., J.-P.D., F.B.), Stroke Center, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=F.%2BBourdain%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Bourdain%20F&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AF.%2BBourdain%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-0757-1346" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for F. Bourdain</a></li></ul></div><div class="author-tooltip-11"><div class="author-tooltip-name">G. Rodesch </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Diagnostic and Interventional Neuroradiology (P.G., O.C., G.R.), Foch Hospital, Suresnes, France</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=G.%2BRodesch%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Rodesch%20G&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AG.%2BRodesch%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-5858-9522" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for G. Rodesch</a></li></ul></div><div class="author-tooltip-12"><div class="author-tooltip-name">M. Piotin </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Diagnostic and Interventional Neuroradiology (R.B., B.B., H.R., M.P.), Rothschild Foundation, Paris, France</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.%2BPiotin%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Piotin%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.%2BPiotin%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-1354-4328" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M. Piotin</a></li></ul></div></div></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article abstract-view "><span class="highwire-journal-article-marker-start"></span><div class="section abstract" id="abstract-1"><h2>Abstract</h2><div id="sec-1" class="subsection"><p id="p-1"><strong>BACKGROUND AND PURPOSE:</strong> Mechanical thrombectomy with stent retrievers is now the standard therapy for selected patients with ischemic stroke. The technique of A Direct Aspiration, First Pass Technique for the Endovascular Treatment of Stroke (ADAPT) appears promising with a high rate of recanalization. We compared ADAPT versus stent retrievers (the Solitaire device) for efficacy and safety as a front-line endovascular procedure.</p></div><div id="sec-2" class="subsection"><p id="p-2"><strong>MATERIALS AND METHODS:</strong> We analyzed 243 consecutive patients with large intracranial artery occlusions of the anterior circulation, treated within 6 hours with mechanical thrombectomy by either ADAPT or the Solitaire stent. Th primary outcome was complete recanalization (modified TICI ≥ 2b); secondary outcomes included complication rates and procedural and clinical outcomes.</p></div><div id="sec-3" class="subsection"><p id="p-3"><strong>RESULTS:</strong> From November 2012 to June 2014, 119 patients were treated with stent retriever (Solitaire FR) and 124 by using the ADAPT with Penumbra reperfusion catheters. The median baseline NIHSS score was the same for both groups (Solitaire, 17 [interquartile range, 11–21] versus ADAPT, 17 [interquartile range, 12–21]). Time from groin puncture to recanalization (Solitaire, 50 minutes [range, 25–80 minutes] versus ADAPT, 45 minutes [range, 27–70 minutes], <em>P</em> = .42) did not differ significantly. However, compared with the Solitaire group, patients treated with ADAPT achieved higher final recanalization rates (82.3% versus 68.9%; adjusted relative risk, 1.18; 95% CI, 1.02–1.37; <em>P</em> = .022), though differences in clinical outcomes between the cohorts were not significant. Use of an adjunctive device was more frequent in the ADAPT group (45.2% versus 13.5%, <em>P</em> &lt; .0001). The rate of embolization in new territories or symptomatic hemorrhage did not differ significantly between the 2 groups.</p></div><div id="sec-4" class="subsection"><p id="p-4"><strong>CONCLUSIONS:</strong> Front-line ADAPT achieved higher recanalization rates than the Solitaire device. Further randomized controlled trials are warranted to define the best strategy for mechanical thrombectomy.</p></div></div><div class="section glossary" id="glossary-1"><h2 class="">ABBREVIATIONS:</h2><dl id="def-list-1"><dt id="def-item-1">ADAPT<span class="def-item-dt-sep"></span></dt><dd>A Direct Aspiration, First Pass Technique for the Endovascular Treatment of Stroke<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">MT<span class="def-item-dt-sep"></span></dt><dd>mechanical thrombectomy<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">mTICI<span class="def-item-dt-sep"></span></dt><dd>modified TICI</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2016 by American Journal of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/37/10/1860.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 37</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 10 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Oct 2016 </div></div>
      
      
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      <div class="highwire-cite-title">A Direct Aspiration, First Pass Technique (ADAPT) versus Stent Retrievers for Acute Stroke Therapy: An Observational Comparative Study</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">B.</span> <span class="nlm-surname">Lapergue</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">R.</span> <span class="nlm-surname">Blanc</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">P.</span> <span class="nlm-surname">Guedin</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">J.-P.</span> <span class="nlm-surname">Decroix</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Labreuche</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">C.</span> <span class="nlm-surname">Preda</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">B.</span> <span class="nlm-surname">Bartolini</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">O.</span> <span class="nlm-surname">Coskun</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">H.</span> <span class="nlm-surname">Redjem</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Mazighi</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">F.</span> <span class="nlm-surname">Bourdain</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">G.</span> <span class="nlm-surname">Rodesch</span></span>, <span class="highwire-citation-author" data-delta="12"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Piotin</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Oct 2016, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">37 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1860-1865; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A4840 </span></div>
  
  
  
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      <div class="highwire-cite-title">A Direct Aspiration, First Pass Technique (ADAPT) versus Stent Retrievers for Acute Stroke Therapy: An Observational Comparative Study</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">B.</span> <span class="nlm-surname">Lapergue</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">R.</span> <span class="nlm-surname">Blanc</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">P.</span> <span class="nlm-surname">Guedin</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">J.-P.</span> <span class="nlm-surname">Decroix</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Labreuche</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">C.</span> <span class="nlm-surname">Preda</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">B.</span> <span class="nlm-surname">Bartolini</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">O.</span> <span class="nlm-surname">Coskun</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">H.</span> <span class="nlm-surname">Redjem</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Mazighi</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">F.</span> <span class="nlm-surname">Bourdain</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">G.</span> <span class="nlm-surname">Rodesch</span></span>, <span class="highwire-citation-author" data-delta="12"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Piotin</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Oct 2016, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">37 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1860-1865; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A4840 </span></div>
  
  
  
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