Study Compares Solumbra and ADAPT Techniques of Mechanical Thrombectomy to Treat Acute Ischemic Stroke

December 15, 2015—Findings from a single-center study comparing rates of symptomatic intracranial hemorrhage (SICH) and good clinical outcome at 90 days in patients with ischemic strokes from anterior circulation emergent large vessel occlusions (ELVO) treated with mechanical thrombectomy using either a Solumbra technique or a direct aspiration first-pass thrombectomy technique (ADAPT) were published by Josser E. Delgado Almandoz, MD, et al online ahead of print in the Journal of NeuroInterventional Surgery.

The investigators concluded that in this study cohort, the ADAPT technique was associated with significantly higher good clinical outcomes at 90 days in patients with acute ischemic stroke because of anterior circulation ELVOs treated with mechanical thrombectomy.

In the study, the investigators compared clinical characteristics, procedural variables, and clinical outcomes in patients with anterior circulation ELVOs treated with mechanical thrombectomy using either a Solumbra or ADAPT technique during a 38-month period at Abbott Northwestern Hospital in Minneapolis, Minnesota. SICH was defined using the SITS-MOST criteria. A good clinical outcome was defined as a modified Rankin Scale score of 0–2 at 90 days.

The study was composed of 100 patients, with 55 in the Solumbra group and 45 in the ADAPT group. 

As summarized in the Journal of NeuroInterventional Surgery,the investigators reported that:

• Patients in the ADAPT group had higher National Institutes of Health Stroke Scale (19.2 vs 16.8; P = .02) and a higher proportion of internal carotid artery terminus thrombi (42.2% vs 20%; P = .03) than patients in the Solumbra group.
• Patients in the ADAPT group had a trend toward a lower rate of SICH than patients in the Solumbra group (2.2% vs 12.7%; P = .07). 
• Patients in the ADAPT group had a significantly higher rate of good clinical outcome at 90 days than patients in the Solumbra group (55.6% vs 30.9%; P = .015). 
• Use of the ADAPT technique (odds ratio, 6; 95% confidence interval, 1.0–31.2; P = .049) was an independent predictor of a good clinical outcome at 90 days in this cohort.