1. ADAPT for Tandem Occlusions
Gyula Gál
Department of Radiology
University Hospital
Odense, Denmark

2. ADAPT, what is that? Long, 0,088 ID sheath to the proximal ICA/VA
Large ID asp cath – 5,4F Penumbra 5Max or 5Max/ACE over a mc of choice to the thrombus up to the M1/A1/P1
Asp with the Penumbra asp pump, >90 sec.
The cath is removed, angio to see vess. pat.

3. 69 yrs male, Lt hemipar. at noon
CT 13.15:occl. Rt MCA & ICA
I v thrombolysis ~2 pm
Transport to OUH
Arrival 5 pm, no remiss.
New CT: dens vessel
Perfusion: no significant penumbra

4. What to do?

5. Good filling of Rt MCA territory

7. Gateway 3,5x9

11. Final angiogram

14. Experiences with 12 cases
Stenosis/occl. of the ICA can easily be reopened w the 5MAX/ACE or a Gateway
Easy navigation of the 5MAX/ACE over a mc of choice, 0,017-0,043” beyond the circle of Willis
Efficient & quick aspiration of thrombus
Several passes if large masses in large vessels, like T-occlusion of the ICA
Still possible to use stentrievers if/when necessary, beyond the M1/A1/P1