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<meta name="DC.Title" content="Necessary Catheter Diameters for Mechanical Thrombectomy with ADAPT" />
<meta name="DC.Identifier" content="10.3174/ajnr.A5401" />
<meta name="DC.Date" content="2017-12-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Large-bore catheters allow mechanical thrombectomy in ischemic stroke by engaging and retrieving clots without additional devices (direct aspiration first-pass technique [ADAPT]). The purpose of this study was to establish a model for minimal catheter diameters needed for ADAPT.

MATERIALS AND METHODS: We established a theoretic model for the calculation of minimal catheter diameters needed for ADAPT. We then verified its validity in 28 ADAPT maneuvers in a porcine in vivo model. To account for different mechanical thrombectomy techniques, we factored in ADAPT with/without a hypothetic 0.021-inch microcatheter or 0.014-inch microwire inside the lumen of the aspiration catheter and aspiration with a 60-mL syringe versus an aspiration pump.

RESULTS: According to our calculations, catheters with an inner diameter of &gt;0.040 inch and &gt;0.064 inch, respectively, are needed to be effective in the middle cerebral artery (2.5-mm diameter) or in the internal carotid artery (4 mm) in an average patient. There was a significant correlation between predicted and actual thrombectomy results ( P = .010). Our theoretic model had a positive and negative predictive value of 78% and 79%, respectively. Sensitivity and specificity were 88% and 64%, respectively.

CONCLUSIONS: Our theoretic model allows estimating the minimal catheter diameters needed for successful mechanical thrombectomy with ADAPT, as demonstrated by the good agreement with our animal experiments. Our model will be helpful to interventionalists in avoiding selecting catheters that are likely too small to be effective.

ADAPT
:   direct aspiration first-pass technique
MT
:   mechanical thrombectomy" />
<meta name="DC.Contributor" content="O. Nikoubashman" />
<meta name="DC.Contributor" content="A. Nikoubashman" />
<meta name="DC.Contributor" content="M. Büsen" />
<meta name="DC.Contributor" content="M. Wiesmann" />
<meta name="article:published_time" content="2017-12-01" />
<meta name="article:section" content="Interventional" />
<meta name="citation_title" content="Necessary Catheter Diameters for Mechanical Thrombectomy with ADAPT" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Large-bore catheters allow mechanical thrombectomy in ischemic stroke by engaging and retrieving clots without additional devices (direct aspiration first-pass technique [ADAPT]). The purpose of this study was to establish a model for minimal catheter diameters needed for ADAPT.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;We established a theoretic model for the calculation of minimal catheter diameters needed for ADAPT. We then verified its validity in 28 ADAPT maneuvers in a porcine in vivo model. To account for different mechanical thrombectomy techniques, we factored in ADAPT with/without a hypothetic 0.021-inch microcatheter or 0.014-inch microwire inside the lumen of the aspiration catheter and aspiration with a 60-mL syringe versus an aspiration pump.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;According to our calculations, catheters with an inner diameter of &amp;gt;0.040 inch and &amp;gt;0.064 inch, respectively, are needed to be effective in the middle cerebral artery (2.5-mm diameter) or in the internal carotid artery (4 mm) in an average patient. There was a significant correlation between predicted and actual thrombectomy results (&lt;i&gt;P&lt;/i&gt; = .010). Our theoretic model had a positive and negative predictive value of 78% and 79%, respectively. Sensitivity and specificity were 88% and 64%, respectively.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Our theoretic model allows estimating the minimal catheter diameters needed for successful mechanical thrombectomy with ADAPT, as demonstrated by the good agreement with our animal experiments. Our model will be helpful to interventionalists in avoiding selecting catheters that are likely too small to be effective.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="citation_publication_date" content="2017/12/01" />
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<meta name="twitter:title" content="Necessary Catheter Diameters for Mechanical Thrombectomy with ADAPT" />
<meta name="twitter:card" content="summary_large_image" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Large-bore catheters allow mechanical thrombectomy in ischemic stroke by engaging and retrieving clots without additional devices (direct aspiration first-pass technique [ADAPT]). The purpose of this study was to establish a model for minimal catheter diameters needed for ADAPT.

MATERIALS AND METHODS: We established a theoretic model for the calculation of minimal catheter diameters needed for ADAPT. We then verified its validity in 28 ADAPT maneuvers in a porcine in vivo model. To account for different mechanical thrombectomy techniques, we factored in ADAPT with/without a hypothetic 0.021-inch microcatheter or 0.014-inch microwire inside the lumen of the aspiration catheter and aspiration with a 60-mL syringe versus an aspiration pump.

RESULTS: According to our calculations, catheters with an inner diameter of &gt;0.040 inch and &gt;0.064 inch, respectively, are needed to be effective in the middle cerebral artery (2.5-mm diameter) or in the internal carotid artery (4 mm) in an average patient. There was a significant correlation between predicted and actual thrombectomy results ( P = .010). Our theoretic model had a positive and negative predictive value of 78% and 79%, respectively. Sensitivity and specificity were 88% and 64%, respectively.

CONCLUSIONS: Our theoretic model allows estimating the minimal catheter diameters needed for successful mechanical thrombectomy with ADAPT, as demonstrated by the good agreement with our animal experiments. Our model will be helpful to interventionalists in avoiding selecting catheters that are likely too small to be effective.

ADAPT
:   direct aspiration first-pass technique
MT
:   mechanical thrombectomy" />
<meta name="og-title" property="og:title" content="Necessary Catheter Diameters for Mechanical Thrombectomy with ADAPT" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/38/12/2277" />
<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: Large-bore catheters allow mechanical thrombectomy in ischemic stroke by engaging and retrieving clots without additional devices (direct aspiration first-pass technique [ADAPT]). The purpose of this study was to establish a model for minimal catheter diameters needed for ADAPT.

MATERIALS AND METHODS: We established a theoretic model for the calculation of minimal catheter diameters needed for ADAPT. We then verified its validity in 28 ADAPT maneuvers in a porcine in vivo model. To account for different mechanical thrombectomy techniques, we factored in ADAPT with/without a hypothetic 0.021-inch microcatheter or 0.014-inch microwire inside the lumen of the aspiration catheter and aspiration with a 60-mL syringe versus an aspiration pump.

RESULTS: According to our calculations, catheters with an inner diameter of &gt;0.040 inch and &gt;0.064 inch, respectively, are needed to be effective in the middle cerebral artery (2.5-mm diameter) or in the internal carotid artery (4 mm) in an average patient. There was a significant correlation between predicted and actual thrombectomy results ( P = .010). Our theoretic model had a positive and negative predictive value of 78% and 79%, respectively. Sensitivity and specificity were 88% and 64%, respectively.

CONCLUSIONS: Our theoretic model allows estimating the minimal catheter diameters needed for successful mechanical thrombectomy with ADAPT, as demonstrated by the good agreement with our animal experiments. Our model will be helpful to interventionalists in avoiding selecting catheters that are likely too small to be effective.

ADAPT
:   direct aspiration first-pass technique
MT
:   mechanical thrombectomy" />
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      <h1 class="highwire-cite-title" id="page-title">Necessary Catheter Diameters for Mechanical Thrombectomy with ADAPT</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">O. Nikoubashman</span>, <span class="highwire-citation-author" data-delta="1">A. Nikoubashman</span>, <span class="highwire-citation-author" data-delta="2">M. Büsen</span> and <span class="highwire-citation-author" data-delta="3">M. Wiesmann</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">December 2017,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">38 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(12) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">2277-2281; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A5401 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-57340--62045686881" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">O. Nikoubashman </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Diagnostic and Interventional Neuroradiology (O.N., M.W.), University Hospital, RWTH Aachen University, Aachen, Germany</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.%2BNikoubashman%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=Nikoubashman%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.%2BNikoubashman%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/0000-0002-2055-4217" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for O. Nikoubashman</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">A. Nikoubashman </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Institute of Physics (A.N.), Johannes Gutenberg University Mainz, Mainz, Germany</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=A.%2BNikoubashman%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=Nikoubashman%20A&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%3AA.%2BNikoubashman%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/0000-0003-0563-825X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A. Nikoubashman</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">M. Büsen </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Institute of Applied Medical Engineering (M.B.), RWTH Aachen University, Aachen, Germany.</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.%2BB%C3%BCsen%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=B%C3%BCsen%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.%2BB%25C3%25BCsen%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/0000-0001-9758-2892" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M. Büsen</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">M. Wiesmann </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Diagnostic and Interventional Neuroradiology (O.N., M.W.), University Hospital, RWTH Aachen University, Aachen, Germany</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.%2BWiesmann%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=Wiesmann%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.%2BWiesmann%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/0000-0002-8261-5513" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M. Wiesmann</a></li></ul></div></div></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 38</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 12 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Dec 2017 </div></div>
      
      
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      <div class="highwire-cite-title">Necessary Catheter Diameters for Mechanical Thrombectomy with ADAPT</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">O.</span> <span class="nlm-surname">Nikoubashman</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Nikoubashman</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Büsen</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Wiesmann</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">Dec 2017, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">38 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(12) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">2277-2281; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A5401 </span></div>
  
  
  
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      <div class="highwire-cite-title">Necessary Catheter Diameters for Mechanical Thrombectomy with ADAPT</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">O.</span> <span class="nlm-surname">Nikoubashman</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Nikoubashman</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Büsen</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Wiesmann</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">Dec 2017, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">38 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(12) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">2277-2281; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A5401 </span></div>
  
  
  
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