Daft (dual aspiration and fluff technique) for stent retrievers in acute ischemic stroke with large vessel occlusion: A successful new technique for early recanalisation

Abstract

Newer techniques of thrombectomy are evolving for early and effective recanalisation. We evaluated the efficacy of new DAFT (Dual Aspiration and Fluff Technique) in the treatment of acute stroke with large vessel occlusion. We retrospectively reviewed the 23 patients with acute large vessel occlusion using a new DAFT technique. We used dual aspiration pump at both 5 MAX ACE aspiration and Neuron MAX 088 6F catheter along with stent retriever. Patients’ demographic profile and time determining factors like puncture to recanalisation time, pass required, reperfusion grade and mRS at 90 days was noted. Informed consent was taken in all the patients. First-pass mTICI 3 reperfusion was achieved in 18 out of 23 patients (78%) with a mean groin puncture to reperfusion time of 39.0min ± 12 and mTICI 3 was accomplished in 19 out of 23 cases (82%) with a maximum of 3 attempts. Successful reperfusion (mTICI ≥ 2b) was achieved in 21 patients (91.30%) with a mean time from groin puncture to reperfusion of 45min ± 20.3. At presentation, the median National Institutes of Health Stroke Scale (NIHSS) score was 12 and favourable clinical outcome at discharge by the modified Rankin score (mRS ≤ 2) was achieved in 14 out of 23 patients (61%). Ninety days follow up was completed in 18 patients with 16 patients (88.89%) showing favourable outcome. This is significant compared to other conventional techniques. DAFT is an effective technique in for early complete reperfusion in patients with LVO.