Intravenous Thrombolysis and Mechanical Thrombectomy for Acute Ischemic Stroke

If patients were eligible for intravenous thrombolysis, 0.9 mg/kg recombinant tissue-type fibrinogen activator (rt-PA) was administered before mechanical thrombectomy according to Chinese guidelines for the endovascular treatment of acute ischemic stroke (15 (link)). The mechanical thrombectomy procedure was performed by two interventional neuroradiologists with 10 years of practice in neurointerventions. The choice of STR or ADAPT was left to the discretion of the operator, usually based on the anatomical location of the thrombus obstruction, preoperative judgment of the etiology and pathogenesis, and the size of the thrombus. All patients were treated with local anesthesia, preferably through the right femoral artery, to establish access. A balloon guide catheter (BGC) was not used in all procedures due to limitations in available device conditions. The ADAPT and SRT techniques have been described previously (16 (link), 17 (link)). Patients received ADAPT using AXS Catalyst-6 (Stryker, USA) as front-line therapy. All stent retriever procedures were performed using the Solitaire FR (Covidien, USA). Meanwhile, intermediate catheters (AXS Catalyst-6) were routinely used. The operator could choose any necessary thrombectomy device and method to obtain an acceptable therapeutic effect if a successful recanalization could not be accomplished after three attempts using SRT or ADAPT.