Use the labels in the right column to find what you want. Or you can go thru them one by one, there are only 29,372 posts. Searching is done in the search box in upper left corner. I blog on anything to do with stroke. DO NOT DO ANYTHING SUGGESTED HERE AS I AM NOT MEDICALLY TRAINED, YOUR DOCTOR IS, LISTEN TO THEM. BUT I BET THEY DON'T KNOW HOW TO GET YOU 100% RECOVERED. I DON'T EITHER BUT HAVE PLENTY OF QUESTIONS FOR YOUR DOCTOR TO ANSWER.
A direct aspiration first pass technique(ADAPT) in mechanical thrombectomy(MT) has been described in recent studies as an efficacious strategy compared to stent retriever(SR). We sought to evaluate for cost differences of ADAPT technique versus SR as an initial approach.
Retrospective analysis of consecutive patients with MT at our institution between 2022-2023. Patients were grouped into ADAPT with/without SR as rescue strategy, and SR as an initial approach with allowance of concomitant aspiration. Direct cost data(consumables) was obtained. Baseline demographics, stroke metrics, procedure outcomes and cost, last follow-up outcomes in modified Rankin Scale(mRS) were compared between two groups.
56 patients were included. Thirty-seven(66.1%) underwent ADAPT, with 11(29.7%) eventually requiring an SR. Mean age was 64.8 years. Average NIHSS score was 13.2 in the ADAPT group and 14.0 in the SR group(p=0.68), with similar proportion of tPA(p=0.53), site-of-occlusion (p=0.66), and tandem occlusion(p=0.69) between groups. Recanalization was achieved in 94.6% of all patients, with an average of 1.9 passes, 89.3% being TICI 2B or above, with no differences between the two groups. Significantly lower cost(p<0.01) was observed in ADAPT($14,243.4) compared to SR($19,003.6). Average follow-up duration was 180.2 days, with mortality of 23.2%. At last follow-up, 55.4% remained functionally independent(mRS<3) with no difference(p=0.56) between the ADAPT(59.5%) and SR(47.4%) groups.
Outcomes were comparable(What were they? 100% recovery?) between the ADAPT and SR groups. ADAPT reduced procedural consumables cost by approximately $5,000(25%), even if stent retrievers were allowed to be used for rescue. Establishing ADPAT as initial approach may bring significant direct cost savings while obtaining similar outcomes.
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